Ductal prostate cancer: contemporary management and outcomes.
OBJECTIVE
To evaluate contemporary management and outcomes of ductal prostate cancer (PCA).


METHODS
We reviewed all patients with ductal PCA and at least 6 months of follow-up seen at UTMB from 1990 to 2005, which comprised 17 patients (mean age: 67.7 years, range 55-87). At time of diagnosis, 11 patients had localized disease (Group 1) and 6 patients had distant metastasis (Group 2).


RESULTS
Treatment of Group 1 patients included radiation and endocrine treatment for at least 2 years (n = 7), radiation alone (n = 2), and radical surgery (n = 2). At a mean follow-up of 3.6 years (r = 1-12 years) 8 patients (67.7%) remained free of recurrence, 1 patient had biochemical recurrence alone, 1 patient had recurrence in the anterior urethra, and the other had progression with metastasis to the brain and subsequent death. In addition to metastasis to regional/distant lymph nodes and bone in Group 2, metastatic sites included brain (n = 1), peritoneum (n = 1), and lung (n = 1). Mean follow-up was 2.3 years (r = 8 months to 4 years). All patients received androgen deprivation. One patient had progression of disease despite lack of biochemical recurrence and is alive at 2.5 years. One patient died from other causes while the 4 remaining patients are in remission at last follow-up.


CONCLUSIONS
Contemporary management of localized ductal PCA with radiation and endocrine therapy yields adequate disease-free survival. Metastatic sites include brain, lung, peritoneum, and anterior urethra, and most patients respond well to endocrine treatment.
Orihuela
Eduardo
E
Division of Urology, Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA. eorihuel@utmb.edu
Green
Justin M
JM
D000368:Aged; D000369:Aged, 80 and over; D044584:Carcinoma, Ductal / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011471:Prostatic Neoplasms / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome