Clinical Outcomes of Intraductal Carcinoma or Cribriform in Radical Prostatectomy Specimens of Men Opting for Active Surveillance: Data from the PRIAS-JAPAN Study - Beyond the Abstract
IDC-P and cribriform are characterized as key prognostic factors after radical prostatectomy (RP) in patients with PC. However, their presence and clinical significance after AS enrollment remains unknown. Therefore, we aimed to examine the presence and predictive factor of IDC-P or cribriform patterns in RP specimens of men who opted for AS and to assess their oncological outcomes.
In this study, all patients had a Gleason grade of 1 at AS enrollment. The percentage of RP specimens with IDC-P or cribriform disease was 34.3%. Only IDC-P growth was 8.8%, and only cribriform growth was 29.9%, and both of them was 4.4%. The rates of PSA recurrence-free survival after RP were significantly lower in the IDC-P or cribriform groups than in those without IDC-P or cribriform. There were no identifiable predictors of IDC-P or cribriform on RP in the patients’ characteristics, including the presence of PI-RADS 4,5 on MRI before RP.
We propose two hypotheses to explain approximately one-third of the RP specimens in men who underwent RP following AS included IDC-P or cribriform patterns. The first hypothesis involves the de novo occurrence of IDC-P or cribriform during AS. This could be explained by the present study’s design as a prospective study, using rigorous eligibility criteria as early stage PC. The second hypothesis involves the underdetection of IDC-P or cribriform lesions on diagnostic biopsy. A previous study reported that the overall detection sensitivity of IDC-P or cribriform growth on biopsy is not high, especially in men eligible for AS.
Our results indicate that repeat biopsy during AS may be essential for the detection of adverse pathologies such as IDC-P or cribriform.
Written by: Yoichiro Tohi, Ryou Ishikawa, Takuma Kato, Jimpei Miyakawa, Ryuji Matsumoto, Keiichiro Mori, Koji Mitsuzuka, Junichi Inokuchi, Masafumi Matsumura, Kenichiro Shiga, Hirohito Naito, Yasuo Kohjimoto, Norihiko Kawamura, Masaharu Inoue, Hidefumi Kinoshita, Kohei Hashimoto, Keisuke Goto, Reiji Haba, Yoshiyuki Kakehi, Mikio Sugimoto
Department of Urology, Faculty of Medicine, Kagawa University, Kagawa, Japan., Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan., Department of Urology, Faculty of Medicine, Kagawa University, Kagawa, Japan., Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Department of Renal and Genito-Urinary Surgery, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan., Department of Urology, Jikei University School of Medicine, Tokyo, Japan., Department of Urology, Tohoku University Graduate School of Medicine, Miyagi, Japan., Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan., Department of Urology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan., Division of Urology, Harasanshin Hospital, Fukuoka, Japan., Department of Urology, Kurashiki Central Hospital, Okayama, Japan., Department of Urology, Wakayama Medical University, Wakayama, Japan., Department of Urology, Osaka International Cancer Institute, Osaka, Japan., Department of Urology, Saitama Cancer Center, Saitama, Japan., Department of Urology and Andrology, General Medical Center, Kansai Medical University, Osaka, Japan., Department of Urology, Sapporo Medical University School of Medicine, Hokkaido, Japan., Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
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