Ductal adenocarcinoma of the prostate: a Hong Kong case series

Kan, Rebecca; Kan, Chi Fai; Wong, Janet Yuen‐Ha; Fu, Kenneth Kam Fung; Ng, Chi Fai; Chan, Steve Wai Hee

doi:10.1007/s11255-014-0793-z

Cited by 6 publications

(8 citation statements)

References 21 publications

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“…[ 16 ] sorely reminded RP could improve the outcomes of DAC with seven patients with no comparison of RT neither. Nevertheless, two of four patients receiving RP in Kan's study had biochemical recurrence 1–2 years post-operation [ 17 ], partly related to delayed diagnosis which meant DAC was more aggressive. Four retrospective studies evaluating the outcomes managed with RP or RT showed conflicting results, with 108, 17, 31 and 41 patients, respectively [ [18] , [19] , [20] , [21] ].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it is necessary to further investigate the outcomes of DAC treated with RP or RT. Only few studies reported the outcomes of DAC management with RP or RT with small sample sizes [ [15] , [16] , [17] , [18] , [19] , [20] , [21] ], but failed to compare the efficacy of the two treatments. In addition, most of these studies lacked robust adjustments of confounding factors.…”

Section: Introductionmentioning

confidence: 99%

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Oncological outcomes of patients with ductal adenocarcinoma of the prostate receiving radical prostatectomy or radiotherapy

Liu

Jin

Qiu

et al. 2021

Asian Journal of Urology

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Objective To evaluate the oncological outcomes of ductal adenocarcinoma of the prostate (DAC) managed with radical prostatectomy (RP) or radiotherapy (RT) and optimize the proper treatment modality to DAC comprehensively. Methods The cohorts included a total of 528 patients from the Surveillance, Epidemiology and End Results (SEER) database, 354 receiving RP and 174 receiving RT. Cox proportional hazards regressions were performed to assess cancer specific mortality (CSM) and overall mortality (OM) between treatment groups. A competing risk analysis was further conducted. Subgroup analyses by age and level of prostate-specific antigen (PSA) were performed. Propensity score matching was implemented. Results Patients managed with RP had lower risks of CSM and OM compared with RT (before matching: Hazard ratio [HR]=0.24, 95% confidence interval [CI] 0.13–0.47 and HR=0.26, 95% CI 0.17–0.40, respectively; after matching: HR=0.18, 95% CI 0.04–0.82 and HR=0.28, 95% CI 0.11–0.70, accordingly). Subgroup analyses demonstrated that patients in the middle tertile of the age or with lower tertile PSA level managed with RP took lower risks of OM significantly (HR=0.18, 95% CI 0.06–0.57, p <0.01 and HR=0.17, 95% CI 0.06–0.54, p <0.01). Conclusion Among patients with DAC, treatment with RP was associated with better survival outcomes in comparison with RT. Patients with DAC in the middle tertile of the age and with lower tertile PSA level benefited the most from RP.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oncological outcomes of patients with ductal adenocarcinoma of the prostate receiving radical prostatectomy or radiotherapy

Liu

Jin

Qiu

et al. 2021

Asian Journal of Urology

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“…[10] Ductal prostate adenocarcinoma was originally called "endometrial carcinoma of the prostate utricle," "cribriform," or "endometrioid" because of the supposed origin from a different precursor than the more common APC, the remnant paramesonephric tissue. [7,9] Melicow and Pachter [11] first described DPC as an exophytic papillary mass projecting into the urethral lumen, with its base in the crater of the utricle or around the verumontanum, histologically resembling female endometrioid adenocarcinoma.…”

Section: Introductionmentioning

confidence: 99%

“…Pure DPC is a rare histological subtype of invasive PCa that accounts for less than 1% of all PCa diagnoses, [6–9] while the mixed ductal plus acinar pattern accounts for less than or equal to 5% of cases. [10]…”

Section: Introductionmentioning

confidence: 99%

“…Compared with APC, DPC is reported to have a higher mortality rate, increased risk of metastases, and significantly lower prostate-specific antigen (PSA) levels at diagnosis. [6][7][8][9] Several features of DPC, such as lower PSA secretion; lower expression of ETS-related gene oncoprotein, phosphatase, and tensin homolog; higher expression of tumor suppressor genes (P16 and P53); and decreased expression of steroid-related markers demonstrate differences in the tumorigenesis compared with that of conventional, acinar PCa. [14][15][16] There is a paucity of data comparing different treatment modalities and related outcomes in DPC; therefore, an appropriate therapeutic approach is not yet fully defined.…”

Section: Introductionmentioning

confidence: 99%

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Ductal prostate cancer: Clinical features and outcomes from a multicenter retrospective analysis and overview of the current literature

Cozzi

Bardoscia²,

Najafi³

et al. 2022

Curr Urol

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ObjectiveThe aim of the study is to evaluate clinical features and outcomes after different therapeutic strategies for ductal prostate adenocarcinoma (DPC), a rare but aggressive subtype of invasive prostate cancer (PCa) accounting for, in the pure and mixed form, 1% or less and 5% or less, respectively, of all the newly diagnosed PCa.Materials and methodsPatients with a proven diagnosis of DPC undergoing surgery, radiotherapy, and androgen deprivation therapy, alone or in combination, were considered for this multicenter, retrospective study. The study assessed overall survival (OS), disease-free survival (DFS), and age-related disease-specific survival.ResultsEighty-one patients met the study inclusion criteria. Pure DPC was found in 29 patients (36%) and mixed ductal-acinar-PCa in 52 patients (64%). After a median follow-up of 63 months (range, 3–206 months), 3- and 5-year OS rates were 84% and 67%, respectively, and 3- and 5-year DFS rates were 54% and 34%, respectively. There were no significant differences in OS or DFS between the pure and mixed DPC groups. Pure DPC was associated with a higher rate of metastatic disease at onset. Patients 74 years or younger had better disease-specific survival (p=0.0019). A subgroup analysis favored radiotherapy as the primary treatment for nonmetastatic, organ-confined DPC (3- and 5-year DFS of 80% and 50%, respectively, compared with 5-year DFS of 35% for surgical patients; p = 0.023).ConclusionsOur study found DPC to be rarer, more aggressive, more likely to metastasize, and have a worse prognosis than the common acinar variant, especially in its pure form. Multicenter series are encouraged to obtain large data sets, or propensity score matching analyses with patients with conventional PCa are desirable to understand the best therapeutic approach and improve outcomes.

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Non-metastatic ductal adenocarcinoma of the prostate: pattern of care from an uro-oncology multidisciplinary group

et al. 2020

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Ductal adenocarcinoma of the prostate: a Hong Kong case series

Abstract: We observed a predilection of this tumour to be locally aggressive, and hence a relatively high incidence of intra-luminal growth and rectal invasion. We observed a high failure rate after either radical prostatectomy or hormonal therapy.

Cited by 6 publications

References 21 publications

Oncological outcomes of patients with ductal adenocarcinoma of the prostate receiving radical prostatectomy or radiotherapy

Oncological outcomes of patients with ductal adenocarcinoma of the prostate receiving radical prostatectomy or radiotherapy

Ductal prostate cancer: Clinical features and outcomes from a multicenter retrospective analysis and overview of the current literature

Non-metastatic ductal adenocarcinoma of the prostate: pattern of care from an uro-oncology multidisciplinary group

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