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

被引:6
作者
Cozzi, Salvatore [1 ]
Bardoscia, Lilia [2 ]
Najafi, Masoumeh [3 ]
Igdem, Sefik [4 ]
Triggiani, Luca [5 ,6 ]
Magrini, Stefano Maria [5 ,6 ]
Botti, Andrea [7 ]
Guedea, Ferran [8 ]
Melocchi, Laura [9 ]
Ciammella, Patrizia [1 ]
Iotti, Cinzia [1 ]
Gutierrez, Cristina [8 ]
机构
[1] Azienda USL IRCCS Reggio Emilia, Dept Radiat Oncol, Reggio Emilia, Italy
[2] Healthcare Co Tuscany Northwest, Dept Radiat Oncol, S Luca Hosp, Lucca, Italy
[3] Iran Univ Med Sci, Dept Radiat Oncol, Shohadaye Haft E Tir Hosp, Tehran, Iran
[4] Istanbul Bilim Univ, Fac Med, Dept Radiat Oncol, Istanbul, Turkey
[5] Univ Brescia, Dept Radiat Oncol, Brescia, Italy
[6] Spedali Civili Hosp, Brescia, Italy
[7] Azienda AUSL IRCCS Reggio Emilia, Dept Med Phys, Reggio Emilia, Italy
[8] Univ Barcelona, Catalan Inst Oncol, Dept Radiat Oncol, Barcelona, Spain
[9] Fdn Poliambulanza Hosp, Dept Pathol, Brescia, Italy
关键词
Androgen deprivation therapy; Mixed ductal-acinar prostate cancer; Pure ductal carcinoma of the prostate; Radiotherapy; Surgery; RADICAL PROSTATECTOMY; ACINAR ADENOCARCINOMA; NEEDLE-BIOPSY; CARCINOMA; RADIOTHERAPY; EXPRESSION; RISK;
D O I
10.1097/CU9.0000000000000118
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objective The 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 methods Patients 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. Results Eighty-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). Conclusions Our 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.
引用
收藏
页码:218 / 226
页数:9
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