MP35-05 INTEGRATING THE PRESENCE OF INTRADUCTAL CARCINOMA OF THE PROSTATE INTO THE GRADE GROUP SYSTEM IMPROVES PREDICTION OF BIOCHEMICAL FAILURE IN RADICAL PROSTATECTOMY PATIENTS

Abstract

You have accessJournal of UrologyProstate Cancer: Markers I1 Apr 2018MP35-05 INTEGRATING THE PRESENCE OF INTRADUCTAL CARCINOMA OF THE PROSTATE INTO THE GRADE GROUP SYSTEM IMPROVES PREDICTION OF BIOCHEMICAL FAILURE IN RADICAL PROSTATECTOMY PATIENTS Masashi Kato, Toyonori Tsuzuki, Ryo Ishida, Tohru Kimura, Osamu Kamihira, Tomoyoshi Ohashi, Tsuyoshi Majima, Yasuhito Funahashi, Naoto Sassa, Yoshihisa Matsukawa, Yasushi Yoshino, Ryohei Hattori, and Momokazu Gotoh Masashi KatoMasashi Kato More articles by this author , Toyonori TsuzukiToyonori Tsuzuki More articles by this author , Ryo IshidaRyo Ishida More articles by this author , Tohru KimuraTohru Kimura More articles by this author , Osamu KamihiraOsamu Kamihira More articles by this author , Tomoyoshi OhashiTomoyoshi Ohashi More articles by this author , Tsuyoshi MajimaTsuyoshi Majima More articles by this author , Yasuhito FunahashiYasuhito Funahashi More articles by this author , Naoto SassaNaoto Sassa More articles by this author , Yoshihisa MatsukawaYoshihisa Matsukawa More articles by this author , Yasushi YoshinoYasushi Yoshino More articles by this author , Ryohei HattoriRyohei Hattori More articles by this author , and Momokazu GotohMomokazu Gotoh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1118AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The ISUP (International Society of Urological Pathology) 2014 and WHO (world health organization) 2016 classifications proposed a grade group system for prostate cancer. Intraductal carcinoma of the prostate (IDC-P) is newly recognized on them and is reported to be strongly associated with high-grade and high-volume invasive prostate cancer. Although the presence of the IDC-P influences biochemical failure in radical prostatectomy patients, only a few studies have mentioned the utility of integrating the presence of IDC-P into the grade group system. METHODS We retrospectively evaluated 1019 patients with prostate cancer who underwent radical prostatectomy without neoadjuvant or adjuvant therapy at the hospitals that the authors were affiliated with between 2005 and 2013. All prostatectomy specimen slides were reviewed by a single genitourinary pathologist according to ISUP 2014 criteria. Recurrence following radical prostatectomy was defined according to AUA guidelines. The endpoint was defined as an increase in prostate-specific antigen (PSA) level. Data on age, PSA level at diagnosis, clinical T stage (cT), pathological T stage (pT), presence of Gleason pattern 5 (GP5), presence of IDC-P, and surgical margin status were analyzed to predict PSA recurrence after prostatectomy. Log rank test and the Cox proportional hazards model were used as statistical test. RESULTS The median patient age was 67 (range, 45-80) years. The median initial PSA was 6.8 ng/ml (range, 0.4-82 ng/ml). The median follow-up period was 69 (range, 0.7-135) months. Pathological T stage was in 67.8% of pT2 (n=691), 4.7% of pT2+ (n=48), 23.4% of pT3a (n=238), and 4.1% of pT3b (n=42). The grade group were as follows: Group 1 without IDC-P, 16.0% (n=163); Group 2 without IDC-P, 46.3% (n=472); Group 3 without IDC-P, 15.6% (n=159); Group 4 without IDC-P, 2.6% (n=26); and Group 5 without IDC-P, 4.2% (n=43); any grade Group with IDC-P, 15.3% (n=156; Group 2 (n=30); Group 3 (n=58); Group 4 (n=13); Group 5 (n=55)). Any grade Group with IDC-P showed a significantly worse prognosis than any other groups without IDC-P (p=.00001). In multivariate analysis, presence of IDC-P, PSA level at diagnosis, presence of GP5, and surgical margin status were significant parameters for predicting (hazard ratio=2.60, 1.81, 1.83, and 2.65; p= <.001, <.001, <.001, and <.001). CONCLUSIONS Integrating the presence of IDC-P into the grade group system will improve the accuracy of patient outcome predictions. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e448-e449 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Masashi Kato More articles by this author Toyonori Tsuzuki More articles by this author Ryo Ishida More articles by this author Tohru Kimura More articles by this author Osamu Kamihira More articles by this author Tomoyoshi Ohashi More articles by this author Tsuyoshi Majima More articles by this author Yasuhito Funahashi More articles by this author Naoto Sassa More articles by this author Yoshihisa Matsukawa More articles by this author Yasushi Yoshino More articles by this author Ryohei Hattori More articles by this author Momokazu Gotoh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...