Presence of Intraductal Carcinoma of the Prostate Is a Significant Prognostic Parameter for Prostate Cancer
Toyonori Tsuzuki, Kyosuke Kimura, Masashi Kato, Ryo Ishida, Naoto Sassa, Ryohei Hattori, Momokazu Gotoh. Nagoya Daini Red Cross Hospital, Nagoya, Japan; Nagoya Medical Center, Nagoya, Japan; Nagoya University Hospital, Nagoya, Japan; Nagoya Firsti Red Cross Hospital, Nagoya, Japan
Background: Presence of intraductal carcinoma of the prostate (IDCP) is an adverse prognostic factor for radical prostatectomy cases. The endpoint in most IDCP studies is prostate-specific antigen (PSA) failure. We aimed to evaluate whether IDCP is also an adverse prognostic factor for cancer-free survival (CFS) and cancer-specific survival (CSS).
Design: We retrospectively evaluated 206 high-risk prostate cancer patients treated with radical prostatectomy between 1991 and 2005 in the hospitals that the authors were affiliated to and reviewed slides of prostatectomy specimens. Data on age, serum PSA level, biopsy Gleason score (bGS, >8 or not), surgical margin (SM), pT stage (pT2 or more), extraprostatic extension (EPE), seminal vesicle invasion (SVI), lymph node metastasis (LN), and neoadjuvant therapy were analyzed. Patient characteristics were analyzed using Fisher's exact test. Multivariate Cox proportional hazard regression models were developed to predict CFS and CSS.
Results: The median age of the patients was 69 years. The median follow-up period was 83 months. IDPC component was detected in 102 patients. Forty-four patients showed clinical failure, and 20 patients died of the disease. Patients with IDCP showed a higher increased PSA level, higher increased bGS, and more advanced stage (including pT, EPE, SVI, and LN) than those without IDCP (p < 0.0001). In univariate analysis, IDCP (p < 0.0001), PSA level (p < 0.0001), bGS (p = 0.0006), SM (p < 0.0001), pT (p < 0.0001), EPE (p = 0.0001), SVI (p < 0.0001), and LN (p < 0.0001) were significantly associated with PFS; IDCP (p = 0.004), PSA level (p < 0.0001), SM (p = 0.0013), pT (p = 0.025), SVI (p = 0.0012), and LN (p = 0.0002) were significantly associated with CSS. In multivariate analysis, IDCP (p = 0.0034; hazard ratio (HR), 3.086), PSA level (p = 0.0129; HR, 1.005), SM (p = 0.0293; HR, 2.155), and bGS (p = 0.0386; HR, 3.489) were significantly associated with PFS; PSA level (p = 0.0009; HR, 1.009) and IDCP (p = 0.0416; HR, 3.884) were significantly associated with CSS.
Conclusions: The presence of IDPC is prognostic factor for both PFS and CSS.
Category: Genitourinary (including renal tumors)
Monday, March 4, 2013 1:00 PM
Poster Session II # 145, Monday Afternoon