Ductal adenocarcinoma of the prostate

Tu, Shi‐Ming; López, Adriana; Leibovici, Dan; Bilen, Mehmet Asım; Evliyaoglu, Ferhat; Aparicio, Ana; Guo, Charles C.; Kuban, Deborah A.; Johnson, M. M.; Pisters, Louis L.

doi:10.1002/cncr.24326

Cited by 53 publications

(19 citation statements)

References 19 publications

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“…3, 5 In a recently published study, Tu etal. 20 showed that, in their cohort of patients, there was a correlation between the composition of the ductal carcinoma (pure versus mixed) and the overall mortality and risk of metastasis. The mixed ductal prostate cancers appeared to be associated with an increased risk of metastasis and increased overall mortality compared with pure ductal carcinomas.…”

Section: Discussionmentioning

confidence: 99%

Ductal Adenocarcinoma of the Prostate: Increased Mortality Risk and Decreased Serum Prostate Specific Antigen

et al. 2010

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Introduction and Objectives The clinical significance of ductal prostatic carcinoma has not been well defined. We utilized a population-based cancer registry to identify a large group of ductal carcinoma cases to characterize the impact of the ductal subtype on the presentation and survival of men with prostate cancer. Methods A national cancer registry was used to identify incident cases of ductal and acinar adenocarcinomas from 1996–2006. Clinicopathologic variables were analyzed and Cox multivariate survival analysis performed. PSA values were available for the years 2004–2006, and these were used to assess for differences in Gleason grade and serum PSA levels between ductal and acinar cancers at the time of diagnosis. Results A total of 442,881 acinar cases and 371 ductal cases were identified. Ductal cases were more likely to present with distant disease (12% vs. 4%, p<0.001) and to be poorly differentiated (50% vs. 32%; p<0.001). Ductal histology was associated with a 30% lowering of the geometric mean PSA (adjusted coeff.=0.7, 95% CI 0.6–0.8) and a more than two-fold increased odds of having a PSA<4.0 ng/ml (OR 2.4, 95% CI 1.4–4.0) independent of other clinicopathologic variables. For those with non-distant disease at diagnosis, ductal histology was associated with a 2.4-fold (CI 1.5–3.8) increased disease-specific mortality. Conclusions In the largest series of this histologic subtype, ductal cancers were more likely to present with advanced stage cancer and a lower PSA, suggesting that timely detection of the disease is a significant challenge. In addition, those with loco regional disease were more likely to die of their disease.

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Section: Discussionmentioning

confidence: 99%

Ductal Adenocarcinoma of the Prostate: Increased Mortality Risk and Decreased Serum Prostate Specific Antigen

et al. 2010

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“…Its histologic appearance is similar to endometrial carcinoma [60]. Clinical characteristics involve presentation with a high Gleason score, local symptoms including intractable urinary symptoms, often atypical visceral metastases, and poor response to hormonal and radiotherapy [60, 61]. TMPRSS2:ERG fusion is reported at similar frequency (50%) as typical prostate acinar adenocarcinomas [62] supporting a same cell of origin.…”

Section: Other Rare Histological Variantsmentioning

confidence: 99%

Emerging Variants of Castration-Resistant Prostate Cancer

2017

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Metastatic castration resistant prostate cancer (CRPC) is associated with substantial clinical, pathologic, and molecular heterogeneity. Most tumors remain driven by androgen receptor (AR) signaling, which has clinical implications for patient selection for AR-directed approaches. However, histologic and clinical resistance phenotypes can emerge after AR-inhibition, in which the tumors become less dependent on the AR. In this review we discuss prostate cancer variants including neuroendocrine (NEPC) and aggressive variant (AVPC) prostate cancers and their clinical implications. Improvements in the understanding of the biologic mechanisms and molecular features underlying prostate cancer variants may help prognostication and facilitate the development of novel therapeutic approaches for subclasses of patient with CRPC.

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“…However, Aydin et al16 stated that prostatic ductal adenocarcinoma was less malignant, slower to progress, and carried a better prognosis than the typical acinar prostate cancer. Tu et al17 reported that prognosis was comparable to other common types of prostate cancer in 25 cases of single histological type prostatic ductal adenocarcinoma, with an overall survival of 13.8 years. Some researchers believe that prognosis for prostatic ductal adenocarcinoma can be closely related to the clinical stage, tumor location, depth of invasion, and other prostate diseases 16,18,19.…”

Section: Discussionmentioning

confidence: 93%

Ductal adenocarcinoma of the prostate: immunohistochemical findings and clinical significance

Sha

Jiang²,

Pan³

et al. 2013

OTT

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IntroductionTo investigate the clinical features, diagnosis, treatment, and prognosis of ductal adenocarcinoma of the prostate.MethodsThe clinicopathological and immunohistochemical data of seven patients with ductal adenocarcinoma of the prostate were retrospectively analyzed. All patients underwent physical examination, magnetic resonance imaging (MRI), bone scan, cystoscopy, and computed tomography (CT) scan. The level of prostate-specific antigen (PSA) before and after surgery was assessed. Different prostate cancer markers were used for immunohistochemical staining.ResultsThe mean age of the seven patients diagnosed with prostatic ductal adenocarcinoma in this study was 76.2 years (range 57–88). Five patients presented with intermittent and painless gross hematuria, one patient with progressive dysuria, and one patient with elevated serum PSA on routine health examination. The level of PSA before surgery ranged from 1.3 to 45.0 ng/mL. Immunohistochemical staining results of the prostatic ductal adenocarcinoma confirmed positivity for PSA, prostatic acid phosphatase, androgen receptor, and alpha-methyacyl co-enzyme A (CoA)-reductase markers. Two of the patients underwent bilateral orchiectomy combined with anti-androgen therapy, three underwent transurethral resection of prostate, one received radical prostatectomy, and one received medical castration therapy. The clinical outcomes of all patients were satisfactory, based on follow-up data. The symptoms of hematuria and dysuria were ameliorated well, and the postoperative PSA level decreased below 4.0 ng/mL. Recurrence or metastasis of disease was not detected on MRI and bone scan.ConclusionDuctal adenocarcinoma of the prostate is a rare subtype of prostate carcinoma, the diagnosis of which could be based on pathological and immunohistochemical examination. Earlier management promises better prognosis.

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Ductal adenocarcinoma of the prostate

Cited by 53 publications

References 19 publications

Ductal Adenocarcinoma of the Prostate: Increased Mortality Risk and Decreased Serum Prostate Specific Antigen

Ductal Adenocarcinoma of the Prostate: Increased Mortality Risk and Decreased Serum Prostate Specific Antigen

Emerging Variants of Castration-Resistant Prostate Cancer

Ductal adenocarcinoma of the prostate: immunohistochemical findings and clinical significance

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