Comparison of Survival Outcomes and Risk Factors Between Ductal Carcinoma of the Prostate and Acinar Adenocarcinoma of the Prostate: A Population-based Propensity Score–matching Study

Wei, Yongbao; Kobayashi, Takuya; Lu, Yan; Vogel, Monica; Zhang, Ruochen; Wu, Jinfeng; Gao, Yunliang; Lin, Lang; Zhu, Qingguo; Ye, Liefu; Horie, Shigeo; Wang, Xianlong; Li, Tao

doi:10.1016/j.euros.2022.10.013

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…The presence of UH has been considered to exhibit treatment resistance to intensitymodulated radiation therapy, androgen-deprivation therapy, and chemotherapy in addition to surgery 7,9,20 . Wei et al indicated that surgical treatment was a favorable option in patients with ductal carcinoma of the prostate as compared to radiation and/or hormonal therapy after PSM analysis 21 . Further investigation is warranted to identify better management options for hard-to-treat histological subtypes.…”

Section: Discussionmentioning

confidence: 99%

Implications of unconventional histological subtypes on magnetic resonance imaging and oncological outcomes in patients who have undergone radical prostatectomy

Kurokawa,

Yamada,

Sakamoto

et al. 2024

Preprint

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The prognostic significance of unconventional histology (UH) subtypes including intraductal carcinoma of the prostate (IDC-P), ductal adenocarcinoma, and cribriform pattern has been investigated for prostate cancer (PCa). However, little is known about magnetic resonance imaging (MRI) features and the oncological impact of tumor localization in localized PCa with UH. Clinical data of 211 patients with acinar adenocarcinoma (conventional histology [CH]) and 82 patients with UH who underwent robotic-assisted radical prostatectomy (RARP) were reviewed. Patients with UH are more likely to be older and have higher Gleason grade group, higher Prostate Imaging-Reporting and Data System (PI-RADS) v2.1 score, and larger TV than those with CH. Multivariate analysis identified the presence of UH as an independent prognostic factor for biochemical recurrence (BCR) (hazard ration (HR) = 2.41, 95% confidence interval (CI): 0.22–0.79, P = 0.0073). No significant difference in BCR was seen regarding tumor localization (transition zone [TZ] or peripheral zone [PZ]) in patients with UH (P = 0.8949), whereas PZ cancer showed shorter BCR-free survival in patients with CH (P = 0.0174). PCa with UH was associated with higher BCR than PCa with CH among resection margin (RM)-negative cases (P < 0.0001). Further, increased PI-RADS v2.1 score did not correlate with larger TV in UH (P = 0.991), whereas a significant difference in TV was observed in CH (P < 0.0001). The prognostic significance of UH tumor was independent of tumor localization, and shorter BCR-free survival was observed even in RM-negative cases, indicating an aggressive subtype with micro-metastatic potential. Furthermore, UH tumors may decrease visibility on MRI. These findings will help optimal perioperative management for PCa with UH.

show abstract

Section: Discussionmentioning

confidence: 99%

Implications of unconventional histological subtypes on magnetic resonance imaging and oncological outcomes in patients who have undergone radical prostatectomy

Kurokawa,

Yamada,

Sakamoto

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…The presence of UH has been considered to exhibit treatment resistance to intensity-modulated radiation therapy, androgen-deprivation therapy, and chemotherapy in addition to surgery 7 , 9 , 21 . Wei et al indicated that surgical treatment was a favorable option in patients with ductal carcinoma of the prostate as compared to radiation and/or hormonal therapy after PSM analysis 22 . Further investigation is warranted to identify better management options for hard-to-treat histological subtypes.…”

Section: Discussionmentioning

confidence: 99%

Implications of unconventional histological subtypes on magnetic resonance imaging and oncological outcomes in patients who have undergone radical prostatectomy

Kurokawa,

Yamada,

Sakamoto

et al. 2024

Sci Rep

View full text Add to dashboard Cite

The prognostic significance of unconventional histology (UH) subtypes including intraductal carcinoma of the prostate (IDC-P), ductal adenocarcinoma, and cribriform pattern has been investigated for prostate cancer (PCa). However, little is known about magnetic resonance imaging (MRI) features and the oncological impact of tumor localization in localized PCa with UH. Clinical data of 211 patients with acinar adenocarcinoma (conventional histology [CH]) and 82 patients with UH who underwent robotic-assisted radical prostatectomy (RARP) were reviewed. Patients with UH are more likely to be older and have higher Gleason grade group, higher Prostate Imaging-Reporting and Data System (PI-RADS) v2.1 score, and larger tumor volume (TV) than those with CH. Multivariate analysis identified the presence of UH as an independent prognostic factor for progression-free survival (PFS) (hazard ration (HR) 2.41, 95% confidence interval (CI) 0.22–0.79, P = 0.0073). No significant difference in PFS was seen regarding tumor localization (transition zone [TZ] or peripheral zone [PZ]) in patients with UH (P = 0.8949), whereas PZ cancer showed shorter PFS in patients with CH (P = 0.0174). PCa with UH was associated with higher progression than PCa with CH among resection margin (RM)-negative cases (P < 0.0001). Further, increased PI-RADS v2.1 score did not correlate with larger TV in UH (P = 0.991), whereas a significant difference in TV was observed in CH (P < 0.0001). The prognostic significance of UH tumor was independent of tumor localization, and shorter PFS was observed even in RM-negative cases, indicating an aggressive subtype with micro-metastatic potential. Furthermore, UH tumors are more likely to harbor a large TV despite PI-RADS v2.1 score ≤ 3. These findings will help optimal perioperative management for PCa with UH.

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“…Prostatic ductal adenocarcinoma is a rare type of prostate cancer, but it is the second most common subtype of prostate cancer behind acinar adenocarcinoma, and on meta-analysis, 0.17% of cases were shown to be pure ductal type [ 11 ]. It is more commonly mixed with acinar adenocarcinoma, being present in 2.6% of prostatic adenocarcinomas [ 12 ] with a significantly higher risk of mortality than acinar adenocarcinoma [ 13 ]. It has a typical columnar cell type and often shows cribriform morphology.…”

Section: Introductionmentioning

confidence: 99%

Genomic Evolution and Transcriptional Changes in the Evolution of Prostate Cancer into Neuroendocrine and Ductal Carcinoma Types

Rao

Protheroe

Cerundolo

et al. 2023

IJMS

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Prostate cancer is typically of acinar adenocarcinoma type but can occasionally present as neuroendocrine and/or ductal type carcinoma. These are associated with clinically aggressive disease, and the former often arises on a background of androgen deprivation therapy, although it can also arise de novo. Two prostate cancer cases were sequenced by exome capture from archival tissue. Case 1 was de novo small cell neuroendocrine carcinoma and ductal adenocarcinoma with three longitudinal samples over 5 years. Case 2 was a single time point after the development of treatment-related neuroendocrine prostate carcinoma. Case 1 showed whole genome doubling in all samples and focal amplification of AR in all samples except the first time point. Phylogenetic analysis revealed a common ancestry for ductal and small cell carcinoma. Case 2 showed 13q loss (involving RB1) in both adenocarcinoma and small cell carcinoma regions, and 3p gain, 4p loss, and 17p loss (involving TP53) in the latter. By using highly curated samples, we demonstrate for the first time that small-cell neuroendocrine and ductal prostatic carcinoma can have a common ancestry. We highlight whole genome doubling in a patient with prostate cancer relapse, reinforcing its poor prognostic nature.

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Comparison of Survival Outcomes and Risk Factors Between Ductal Carcinoma of the Prostate and Acinar Adenocarcinoma of the Prostate: A Population-based Propensity Score–matching Study

Cited by 5 publications

References 23 publications

Implications of unconventional histological subtypes on magnetic resonance imaging and oncological outcomes in patients who have undergone radical prostatectomy

Implications of unconventional histological subtypes on magnetic resonance imaging and oncological outcomes in patients who have undergone radical prostatectomy

Implications of unconventional histological subtypes on magnetic resonance imaging and oncological outcomes in patients who have undergone radical prostatectomy

Genomic Evolution and Transcriptional Changes in the Evolution of Prostate Cancer into Neuroendocrine and Ductal Carcinoma Types

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