Prognostic value of intraductal carcinoma of the prostate in radical prostatectomy specimens.
BACKGROUND
Intraductal carcinoma of the prostate (IDC-P) is an adverse prognostic factor for radical prostatectomy (RP). The endpoint in most IDC-P studies is increased prostate-specific antigen (PSA) levels. The aim of this study was to evaluate whether IDC-P in RP specimens is an adverse prognostic factor for progression-free survival (PFS) and cancer-specific survival (CSS).


METHODS
We retrospectively evaluated 206 high-risk prostate cancer patients treated with RP and analyzed data on age, serum PSA level at diagnosis, biopsy Gleason score (bGS), surgical margin (SM), clinical T stage (cT), extraprostatic extension (EPE), seminal vesicle invasion (SVI), lymph node metastasis (LN), and neoadjuvant therapy.


RESULTS
An IDC-P component was found in 104 cases. Forty-four patients experienced clinical failure, and 20 patients died of the disease. Patients with IDC-P showed a higher bGS and stage (including cT, EPE, SVI, and LN) than those without IDC-P. In univariate analysis, IDC-P, PSA level, bGS, SM, cT, SVI, LN, and EPE (P < 0.0001) were significantly associated with PFS. IDC-P (P = 0.0004), PSA level (P < 0.0001), SM (P = 0.0013), cT (P = 0.0019), SVI (P = 0.0012), and LN (P = 0.0002) were significantly associated with CSS. In multivariate analysis, IDC-P (P = 0.0038), and cT (P = 0.0001) were significantly associated with PFS. IDC-P (P = 0.0238) and PSA level (P = 0.0112) were significantly associated with CSS.


CONCLUSIONS
IDC-P in RP specimens was an independent risk factor for PFS and CSS and could predict clinical outcomes.
Department of Urology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Kyosuke
K
Kimura
Toyonori
T
Tsuzuki
Masashi
M
Kato
Akiko M
AM
Saito
Naoto
N
Sassa
Ryo
R
Ishida
Hiroki
H
Hirabayashi
Yasushi
Y
Yoshino
Ryohei
R
Hattori
Momokazu
M
Gotoh
D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology* / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies
D017430:Prostate-Specific Antigen
cancer-specific survival; clinical outcome; clinical progression-free survival; intraductal carcinoma of the prostate; prostate cancer; radical prostatectomy