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Ductal prostate cancer: Clinical features and outcomes from a multicenter retrospective analysis and overview of the current literature
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, respec...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9875213/ https://www.ncbi.nlm.nih.gov/pubmed/36714233 http://dx.doi.org/10.1097/CU9.0000000000000118 |
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author | Cozzi, Salvatore Bardoscia, Lilia Najafi, Masoumeh Igdem, Sefik Triggiani, Luca Magrini, Stefano Maria Botti, Andrea Guedea, Ferran Melocchi, Laura Ciammella, Patrizia Iotti, Cinzia Gutierrez, Cristina |
author_facet | Cozzi, Salvatore Bardoscia, Lilia Najafi, Masoumeh Igdem, Sefik Triggiani, Luca Magrini, Stefano Maria Botti, Andrea Guedea, Ferran Melocchi, Laura Ciammella, Patrizia Iotti, Cinzia Gutierrez, Cristina |
author_sort | Cozzi, Salvatore |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9875213 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-98752132023-01-26 Ductal prostate cancer: Clinical features and outcomes from a multicenter retrospective analysis and overview of the current literature Cozzi, Salvatore Bardoscia, Lilia Najafi, Masoumeh Igdem, Sefik Triggiani, Luca Magrini, Stefano Maria Botti, Andrea Guedea, Ferran Melocchi, Laura Ciammella, Patrizia Iotti, Cinzia Gutierrez, Cristina Curr Urol Special Topic: Advances in Prostate Cancer Therapy: Original Articles 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. Lippincott Williams & Wilkins 2022-12 2022-08-31 /pmc/articles/PMC9875213/ /pubmed/36714233 http://dx.doi.org/10.1097/CU9.0000000000000118 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Special Topic: Advances in Prostate Cancer Therapy: Original Articles Cozzi, Salvatore Bardoscia, Lilia Najafi, Masoumeh Igdem, Sefik Triggiani, Luca Magrini, Stefano Maria Botti, Andrea Guedea, Ferran Melocchi, Laura Ciammella, Patrizia Iotti, Cinzia Gutierrez, Cristina Ductal prostate cancer: Clinical features and outcomes from a multicenter retrospective analysis and overview of the current literature |
title | Ductal prostate cancer: Clinical features and outcomes from a multicenter retrospective analysis and overview of the current literature |
title_full | Ductal prostate cancer: Clinical features and outcomes from a multicenter retrospective analysis and overview of the current literature |
title_fullStr | Ductal prostate cancer: Clinical features and outcomes from a multicenter retrospective analysis and overview of the current literature |
title_full_unstemmed | Ductal prostate cancer: Clinical features and outcomes from a multicenter retrospective analysis and overview of the current literature |
title_short | Ductal prostate cancer: Clinical features and outcomes from a multicenter retrospective analysis and overview of the current literature |
title_sort | ductal prostate cancer: clinical features and outcomes from a multicenter retrospective analysis and overview of the current literature |
topic | Special Topic: Advances in Prostate Cancer Therapy: Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9875213/ https://www.ncbi.nlm.nih.gov/pubmed/36714233 http://dx.doi.org/10.1097/CU9.0000000000000118 |
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