Prognostic Significance of the Proportion of Ductal Component in Ductal Adenocarcinoma of the Prostate

Abstract

The prognosis for ductal adenocarcinoma can be stratified by the proportion of the ductal component. This marker could potentially be used as a surrogate for poor prognosis or as a determinant for adjuvant therapy.

Does ductal adenocarcinoma of the prostate (DA) have any prognostic impact on patients with de novo metastatic prostate cancer?

“…In general, DA is recognized as an adverse prognostic factor. 4,5,[10][11][12][13][14][15][16] In the present study, the prognostic Cases with IDC-P vs cases with pure AC.…”

“…3 Usually, DA presents in two forms: pure DA and DA mixed with acinar adenocarcinoma of the prostate (AC). 4,5 It was reported that mixed DA accounts for 3.0 to 12.7% of all PCa patients, while pure DA accounts for less than 1.0% of all PCa patients. 6 Although still controversial, 7 the presence of DA in either radical prostatectomy (RP) specimens or prostate biopsy (PBx) specimens is generally known as an adverse prognostic factor in patients with nonmetastatic PCa.…”

“…A number of clinical studies have demonstrated that the presence of DA is not only associated with a higher chance of harboring extraprostatic extension, seminal vesicle invasion and a positive surgical margin in RP treatment 8,9 but is also highly related to early relapse and a much shorter survival time after radical treatment. 4,5,[10][11][12][13][14][15][16] Notably, it has been reported that DA is more frequently detected in patients with metastatic PCa (mPCa) than in those with localized PCa. 13,14 More importantly, DA is more commonly accompanied by visceral metastases and regional metastasis in the penis.…”

High ductal proportion predicts biochemical recurrence in prostatic ductal adenocarcinoma

“…While the study by Jang et al. suggested this relationship, it did not distinguish ductal percentage as an independent risk factor for recurrence from the greater tumour volume typically observed in ductal tumours. Our present study supports the growing consensus that high ductal proportion heralds poor prognosis, but further establishes that this occurs regardless of PTI (as a surrogate of tumour volume, controlling for prostate size).…”

“…While high ductal proportions have been presumed to be associated with poor prognosis, the literature supporting this conclusion is inconsistent, suggesting either no relationship or, in a single study, an increased risk of BCR with high ductal proportion . While the study by Jang et al.…”