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Prognostic value of intraductal carcinoma of the prostate in radical prostatectomy specimens
Author(s) -
Kimura Kyosuke,
Tsuzuki Toyonori,
Kato Masashi,
Saito Akiko M.,
Sassa Naoto,
Ishida Ryo,
Hirabayashi Hiroki,
Yoshino Yasushi,
Hattori Ryohei,
Gotoh Momokazu
Publication year - 2014
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.22786
Subject(s) - medicine , prostatectomy , urology , prostate cancer , stage (stratigraphy) , prostate specific antigen , prostate , univariate analysis , t stage , lymph node , oncology , gynecology , cancer , multivariate analysis , paleontology , biology
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. Prostate 74:680–687, 2014. © 2014 Wiley Periodicals, Inc.