Intraductal carcinoma as an independent predictive factor in prostate biopsy

This study evaluated whether the presence of intraductal carcinoma of the prostate (IDC-P) in prostate biopsies predicts a poorer prognosis.

Prostate cancer is often a slow growing cancer with good prognosis (the predicted outcome of the disease is good). Unfortunately, in some cases relapse occurs and the risk of mortality (death) increases.

Intraductal carcinoma of the prostate (IDC-P) is a particular growth pattern, which can be seen under the microscope. It is associated with increased prostate-specific antigen (PSA; a protein produced by the prostate) levels after surgical removal of the prostate. Increased PSA levels after surgery can indicate that a patient has a poorer prognosis. However, PSA levels can rise without worsening of the disease, and it is not known whether IDC-P itself can predict worse outcomes for patients.

This study evaluated 206 high-risk prostate cancer patients treated with radical prostatectomy (surgical removal of the prostate). 104 of these patients (50.5%) were found to have IDC-P present in their biopsies (tissue removed from a living body to discover the presence or extent of cancer). Patient follow-up occurred for an average of 7 years.

The cancer reappeared in 44 patients (21.4%).  79.5% of these patients had IDC-P. Overall 20 patients (9.7%) died of prostate cancer, 85% of these had IDC-P. The presence of IDC-P decreased the time until disease progressed by 3.07 times. It increased the risk of cancer-related mortality by 4.48 times. 

The authors concluded that the presence of IDC-P was linked to poorer outcome for patients. As a result of this, they suggest that doctors’ reports should include the presence or absence of IDC-P, and that this should be taken into account when planning treatment.