Any proportion of ductal adenocarcinoma in radical prostatectomy specimens predicts extraprostatic extension

Samaratunga, Hemamali, Duffy, David, Yaxley, John and Delahunt, Brett (2010) Any proportion of ductal adenocarcinoma in radical prostatectomy specimens predicts extraprostatic extension. Human Pathology, 41 2: 281-285. doi:10.1016/j.humpath.2009.08.010


Author Samaratunga, Hemamali
Duffy, David
Yaxley, John
Delahunt, Brett
Title Any proportion of ductal adenocarcinoma in radical prostatectomy specimens predicts extraprostatic extension
Journal name Human Pathology   Check publisher's open access policy
ISSN 0046-8177
1532-8392
Publication date 2010
Year available 2010
Sub-type Article (original research)
DOI 10.1016/j.humpath.2009.08.010
Open Access Status
Volume 41
Issue 2
Start page 281
End page 285
Total pages 5
Place of publication Maryland Heights, MO United States
Publisher W.B. Saunders Co.
Collection year 2010
Language eng
Subject 2734 Pathology and Forensic Medicine
Abstract Ductal adenocarcinoma of the prostate is an aggressive malignancy, often presenting at an advanced stage. In mixed ductal and acinar adenocarcinomas, the relationship between the proportion of the ductal component of the tumor and the pathologic stage and whether or not aggressive behavior is simply a function of grade remains undetermined. From 268 consecutive radical prostatectomies undertaken as a curative procedure for clinical localized prostate cancer, we identified 34 cases (12.7%) with ductal adenocarcinoma of the prostate comprising 5% to 100% of the total tumor volume. For cases with a ductal adenocarcinoma of the prostate component, the mean age at diagnosis of 60 years (range 49-69 years), mean serum prostate-specific antigen of 8.4 ng/mL (range, 0.8-21 ng/mL) and positive surgical margin rate of 17.6% did not differ significantly from that of the pure adenocarcinoma group. All 34 patients with ductal adenocarcinoma of the prostate had peripheral zone involvement while 16 (46%) also had transition zone involvement. Twenty-five (73%) cases with ductal adenocarcinoma of the prostate had extraprostatic extension (pT3), which compared to 32.9% with acinar adenocarcinoma. The presence of ductal adenocarcinoma of the prostate (P < .0001), high tumor volume (P = .001) and Gleason score >7 (P = .04) significantly predicted pT3 staging category, and the presence of ductal adenocarcinoma of the prostate remained a significant predictor for pT3, after adjusting for tumor volume and Gleason score >7. The proportion of ductal adenocarcinoma of the prostate did not significantly modify the strength of the observed association with pathological stage. In view of the significant association with extraprostatic extension we would recommend that in both core biopsies and radical prostatectomy specimens any proportion of ductal adenocarcinoma of the prostate should be reported.
Keyword Adenocarcinoma
Ductal adenocarcinoma
Gleason grade
Prostate
Tumor stage
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Sustainable Minerals Institute Publications
 
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