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Mucinous adenocarcinoma of prostate and prostatic adenocarcinoma with mucinous components: a clinicopathological analysis of 143 cases
Author(s) -
Samaratunga Hemamali,
Delahunt Brett,
Srigley John R,
Yaxley John,
Johannsen Shulammite,
Coughlin Geoffrey,
Gianduzzo Troy,
Kua Boon,
Patterson Imogen,
Nacey John N,
Egevad Lars
Publication year - 2017
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13278
Subject(s) - mucinous carcinoma , medicine , adenocarcinoma , grading (engineering) , prostate , pathological , prostate cancer , urology , pathology , prostatectomy , cancer , biology , ecology
Aim The clinical significance of mucinous prostatic adenocarcinoma ( PC a) remains uncertain. Methods From 6440 cases of PC a treated by radical prostatectomy from 2009 to 2014, mucinous components of 5–100% were found in 143 (2.2%) cases. Results The mean age was 61.4 years, mean pre‐operative serum prostate‐specific antigen ( PSA ) was 7.8 ng/ml and clinical stage category was cT 1 in 81% and cT 2 in 19% of cases. Cases were graded using the 2014 International Society of Urological Pathology recommendation of grading underlying architecture, and Gleason scores ( GS ) were 3 + 4 in 13.3%, 4 + 3 in 54.5%, 4 + 4 in 2.1%, 3 + 4 or 4 + 3 with tertiary 5 in 11.9% and 9–10 in 18.2%. The mucinous component invariably had a high‐grade component. Extraprostatic extension was found in 46.8% of cases. In 21.6%, tumour volume was ≥3 cm³ and 9.7% had surgical margin positivity. Seminal vesicle involvement was found in 6.9%. In 73 cases the mucinous component was >25%, and when cases were divided on the basis of the area of mucin present (≤25 versus >25%) there was no significant difference between clinical or pathological features. Similar findings were achieved when cases were compared with grade‐matched non‐mucinous carcinoma controls. The 5‐year biochemical recurrence rates for mucinous versus non‐mucinous cancer were 12.5 versus 17% ( P = 0.15). Conclusion PC a with mucinous components is often high grade; however, the prognosis appears to be similar to non‐mucinous cancers of similar GS .