title: The presence of intraductal carcinoma of the prostate in needle biopsy is a significant prognostic factor for prostate cancer patients with distant metastasis at initial presentation.
abstract: Intraductal carcinoma of the prostate is an adverse prognostic factor in localized prostate cancer patients. However, whether it influences outcome of those patients with distant metastases discovered at initial diagnosis is unclear. Here, we evaluated whether the presence of intraductal carcinoma of the prostate in prostate needle biopsies is an adverse prognostic factor for cancer-specific survival and overall survival in such prostate cancer patients. We retrospectively enrolled 150 eligible patients. All patients received androgen-deprivation therapy and/or chemotherapy. Their age, performance status, pain, metastatic sites, clinical T stage, serum prostate-specific antigen, alkaline phosphatase, hemoglobin, Gleason score, and the presence of Gleason pattern 5 were analyzed. Primary end point was cancer-specific survival; secondary end points included prostate-specific antigen progression-free survival and overall survival. Fine and Gray's model and the Cox proportional hazards model were used as statistical tests. Intraductal carcinoma of the prostate was detected in 100 (67%) patients. At a median follow-up of 38 months, 79 patients (53%) had died of the disease and nine (6%) had died of other causes. The average time interval to cancer-related death was 28 months. On multivariate analysis, only intraductal carcinoma of the prostate was significantly associated with cancer-specific survival (P=0.018) and overall survival (P=0.001), and only the presence of Gleason pattern 5 was significantly associated with prostate-specific antigen progression-free survival (P=0.026). The presence of intraductal carcinoma of the prostate was the only significant prognostic parameter for cancer-specific survival and overall survival in prostate cancer patients with distant metastasis at presentation. These results may prove useful in planning future treatments.
authors.affiliation: Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Pathology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan.
authors.forename: Toyonori
authors.initials: T
authors.lastname: Tsuzuki
authors.affiliation: Department of Urology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hirakawa
authors.affiliation: Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan.
authors.forename: Fumie
authors.initials: F
authors.lastname: Kinoshita
authors.affiliation: Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Sassa
authors.affiliation: Department of Urology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Ishida
authors.affiliation: Department of Urology, Komaki City Hospital, Komaki, Japan.
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Fukatsu
authors.affiliation: Department of Urology, Chukyo Hospital, Nagoya, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Funahashi
authors.affiliation: Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Matsukawa
authors.affiliation: Department of Urology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Hattori
authors.affiliation: Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
authors.forename: Momokazu
authors.initials: M
authors.lastname: Gotoh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001707:Biopsy, Needle; D021441:Carcinoma, Pancreatic Ductal / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D018572:Disease-Free Survival; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal