Clinical outcomes of intraductal carcinoma or cribriform in radical prostatectomy specimens of men opting for active surveillance: data from the PRIAS–JAPAN study

Tohi, Yoichiro; Ishikawa, Ryou; Kato, Takuma; Miyakawa, Jimpei; Matsumoto, Ryuji; Mori, Keiichiro; Mitsuzuka, Koji; Inokuchi, Junichi; Matsumura, Masafumi; Shiga, Kenichiro; Naito, Hirohito; Kohjimoto, Yasuo; Kawamura, Norihiko; Inoue, Masaharu; Kinoshita, Hidefumi; Hashimoto, Kimio; Goto, Keisuke; Haba, Reiji; Kakehi, Yoshiyuki; Sugimoto, Mikio

doi:10.1007/s10147-022-02277-8

Cited by 10 publications

(9 citation statements)

References 30 publications

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“…There have been a number of studies which have reported the presence of cribriform glands and intraductal carcinoma of the prostate (IDC‐P) being associated with more aggressive PC and poorer prognosis. 29 There has been debate between pathologists as to whether the presence of cribriform glands should equate to Gleason pattern 3 or 4. The current recommendation from the Royal College of Pathologists is that their presence should indicate Gleason pattern 4.…”

Section: Discussionmentioning

confidence: 99%

A contemporary analysis of disease upstaging of Gleason 3 + 3 prostate cancer patients after robot‐assisted laparoscopic prostatectomy

Taggart,

Dutto,

Leung

et al. 2023

Cancer Medicine

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BackgroundRisk of biochemical recurrence (BCR) in localised prostate cancer can be stratified using the 5‐tier Cambridge Prognostic Group (CPG) or 3‐tier European Association of Urology (EAU) model. Active surveillance is the current recommendation if CPG1 or EAU low‐risk criteria are met. We aimed to determine the contemporary rates of upgrading, upstaging and BCR after radical prostatectomy for CPG1 or EAU low‐risk disease.MethodsA database of all robotic‐assisted laparoscopic prostatectomies (RALPs) performed in Glasgow between 12/2015 and 05/2022 was analysed. Rates of upgrading, upstaging and BCR post‐RALP for CPG1 or EAU low‐risk disease were defined. Univariate and multivariate analysis were performed to assess the relationship between patient factors and outcomes.ResultsA total of 1223 RALP cases were identified. A total of 12.6% met CPG1 criteria with 70.1% and 25.3% upgraded and upstaged to extraprostatic disease post‐operatively respectively. A total of 5.8% met EAU low‐risk criteria with 60.6% upgraded and 25.4% upstaged to extraprostatic disease post‐operatively respectively. CPG1 (p < 0.0001) and EAU low‐risk (p = 0.02) patients were at a significantly higher risk of BCR if upstaged.DiscussionMany patients who met CPG1 or EAU low‐risk criteria were upgraded post‐RALP and approximately 25% were upstaged due to extraprostatic disease. Upstaging puts patients at a significantly higher risk of BCR.

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Section: Discussionmentioning

confidence: 99%

A contemporary analysis of disease upstaging of Gleason 3 + 3 prostate cancer patients after robot‐assisted laparoscopic prostatectomy

Taggart,

Dutto,

Leung

et al. 2023

Cancer Medicine

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“…58 Tohi et al evaluated patients who had undergone RP after AS and found that PI-RADS 4 or 5 on MRI before RP was not a predictor of the presence of IDC-P or CA in RP. 9 Ericson et al reported that MRI fusion biopsy did not improve the sensitivity of IDC-P or CA detection compared to systematic biopsy (53.5% vs. 56.5%). 8 These studies suggest that mpMRI can detect IDC-P and that MRI alone has insufficient sensitivity to detect IDC-P.…”

Section: Radiographic Featuresmentioning

confidence: 98%

“…In the Prostate Cancer Research International Active Surveillance (PRIAS)‐JAPAN study, 137 RP specimens from 137 prostate cancer patients who had selected active surveillance (AS) and then underwent RP were reviewed. The results showed that 13.2% had IDC‐P, suggesting that there are a certain number of false‐negative IDC‐P cases in the AS cohort as well 9 …”

Section: Epidemiologymentioning

confidence: 98%

“…Tohi et al. evaluated patients who had undergone RP after AS and found that PI‐RADS 4 or 5 on MRI before RP was not a predictor of the presence of IDC‐P or CA in RP 9 . Ericson et al.…”

Section: Radiographic Featuresmentioning

confidence: 99%

“…The results showed that 13.2% had IDC-P, suggesting that there are a certain number of false-negative IDC-P cases in the AS cohort as well. 9 CLINICAL FEATURES Kweldam et al examined diagnostic biopsy specimens from 1031 males with prostate cancer and found that the presence of IDC-P was significantly associated with worse diseasespecific survival independent of GS in multivariate analysis (hazard ratio [HR] = 2.6; 95% CI = 1.4-4.8). 10 Many studies have evaluated the prognostic value of IDC-P in RP, and the presence of IDC-P has been demonstrated to independently predict a higher GS at RP, a larger tumor volume, extracapsular invasion, seminal vesicle invasion, pelvic lymph node metastasis, worse postoperative progression-free survival, and biochemical recurrence.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Recent insights on the clinical, pathological, and molecular features of intraductal carcinoma of the prostate

Naito,

Kato,

Nagayama

et al. 2023

Int J of Urology

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Intraductal carcinoma of the prostate, a unique histopathologic entity that is often observed (especially in advanced prostate cancer), is characterized by the proliferation of malignant cells within normal acini or ducts surrounded by a basement membrane. Intraductal carcinoma of the prostate is almost invariably associated with an adjacent high‐grade carcinoma and is occasionally observed as an isolated subtype. Intraductal carcinoma of the prostate has been demonstrated to be an independent poor prognostic factor for all stages of cancer, whether localized, de novo metastatic, or castration‐resistant. It also has a characteristic genetic profile, including high genomic instability. Recognizing and differentiating it from other pathologies is therefore important in patient management, and morphological diagnostic criteria for intraductal carcinoma of the prostate have been established. This review summarizes and outlines the clinical and pathological features, differential diagnosis, molecular aspects, and management of intraductal carcinoma of the prostate, as described in previous studies. We also present a discussion and future perspectives regarding intraductal carcinoma of the prostate.

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Assessing the predictive value of intraductal carcinoma of the prostate (IDC‐P) in determining abiraterone efficacy for metastatic hormone‐sensitive prostate cancer (mHSPC) patients

Wei,

Zhao,

Nie

et al. 2024

The Prostate

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BackgroundThis study explored the value of intraductal carcinoma of the prostate (IDC‐P) in predicting the efficacy of abiraterone treatment in metastatic hormone‐sensitive prostate cancer (mHSPC) patients.MethodsA retrospective study of 925 patients who underwent prostate biopsies to detect IDC‐P was conducted, with participants divided into two cohorts. The first cohort of 165 mHSPC patients receiving abiraterone treatment was analyzed to compare therapeutic effectiveness between IDC‐P positive and negative cases. Utilizing propensity score matching (PSM) to reduce bias, outcomes such as PSA response, progression‐free survival (PSA‐PFS), radiographic progression‐free survival (rPFS), and overall survival were assessed. Additionally, the second cohort of 760 mHSPC patients compared the efficacy of abiraterone with conventional hormone therapy, focusing on differences between IDC‐P positive and negative individuals.ResultsAfter PSM, our first cohort included 108 patients with similar baseline characteristics. Among them, 50% (54/108) were diagnosed with IDC‐P, with 22.2% (12/54) having IDC‐P pattern 1 and 77.8% (42/54) with IDC‐P pattern 2. While no notable difference was seen in PSA responses between IDC‐P positive and negative patients, IDC‐P presence linked to worse clinical outcomes (PSA‐PFS: 18.6 months vs. not reached [NR], p = 0.009; rPFS: 23.6 months vs. NR, p = 0.020). Further analysis showed comparable outcomes for IDC‐P pattern 1 but significantly worse prognosis for IDC‐P pattern 2 (PSA‐PFS: 18.6 months vs. NR, p = 0.002; rPFS: 22.4 months vs. NR, p = 0.010). Subgroup analysis revealed IDC‐P pattern 2 consistently predicted poorer outcomes across patient subgroups. Remarkably, both IDC‐P positive and negative patients gained more from androgen deprivation therapy with abiraterone than conventional treatment, with IDC‐P negative patients showing a more significant survival advantage, supported by better hazard ratios (0.47 and 0.66).ConclusionThis study found that IDC‐P, especially pattern 2, predicts poor prognosis in mHSPC patients on abiraterone therapy. Also, abiraterone's advantage over hormone therapy is reduced in cases with IDC‐P compared to those without.

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Clinical outcomes of intraductal carcinoma or cribriform in radical prostatectomy specimens of men opting for active surveillance: data from the PRIAS–JAPAN study

Cited by 10 publications

References 30 publications

A contemporary analysis of disease upstaging of Gleason 3 + 3 prostate cancer patients after robot‐assisted laparoscopic prostatectomy

A contemporary analysis of disease upstaging of Gleason 3 + 3 prostate cancer patients after robot‐assisted laparoscopic prostatectomy

Recent insights on the clinical, pathological, and molecular features of intraductal carcinoma of the prostate

Assessing the predictive value of intraductal carcinoma of the prostate (IDC‐P) in determining abiraterone efficacy for metastatic hormone‐sensitive prostate cancer (mHSPC) patients

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