MP62-05 IMPACT OF INTRA-DUCTAL CARCINOMA ON CLINICAL OUTCOMES IN MEN WITH PROSTATE CANCER: SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

You have accessJournal of UrologyProstate Cancer: Staging I (MP62)1 Apr 2020MP62-05 IMPACT OF INTRA-DUCTAL CARCINOMA ON CLINICAL OUTCOMES IN MEN WITH PROSTATE CANCER: SYSTEMATIC REVIEW AND META-ANALYSIS Jatinder Kumar*, Shiva Gautam, Daniel Norez, Muhhamad Alam, Karthik Tanneru, Soroush Bazargani, Syed Behzaad Jazayeri, Hariharan Palayapalayam Ganapathi, Mark Bandyk, Joseph Costa, Shahriar Koochekpour, and KC Balaji Jatinder Kumar*Jatinder Kumar* More articles by this author , Shiva GautamShiva Gautam More articles by this author , Daniel NorezDaniel Norez More articles by this author , Muhhamad AlamMuhhamad Alam More articles by this author , Karthik TanneruKarthik Tanneru More articles by this author , Soroush BazarganiSoroush Bazargani More articles by this author , Syed Behzaad JazayeriSyed Behzaad Jazayeri More articles by this author , Hariharan Palayapalayam GanapathiHariharan Palayapalayam Ganapathi More articles by this author , Mark BandykMark Bandyk More articles by this author , Joseph CostaJoseph Costa More articles by this author , Shahriar KoochekpourShahriar Koochekpour More articles by this author , and KC BalajiKC Balaji More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000937.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Intra-ductal carcinoma of the prostate (IDC-P) is an aggressive variant of prostate cancer (PC) that is associated with characteristic molecular and genetic features with the incidence of approximately 20%. The available studies have shown that identification of IDC-P in PC tissue to be an independent variable in the prediction of pathological stage, tumor volume, Gleason score, and treatment failure. The effect of IDC-P on clinical outcomes is yet to be clarified. We carried out a systematic review and meta-analysis of clinical outcomes in patients with IDC-P. METHODS: A meta-analysis by fixed-effect model was conducted using 12 studies reporting hazard ratio (HR) and meeting our selection criteria, which included the patient population, intervention, outcome, study design approach, and selected endpoints. In men with PC with or without IDC-P; we compared castration-resistant free survival (CFS) and overall survival (OS) for metastatic-PC with IDC-P (Group 1), biochemical recurrence free (BRF) and/or cancer-specific survival (CSS). Patients were analyzed in two groups; with localized-PC and IDC-P undergoing radical prostatectomy (Group 2a) or radiotherapy (Group 2b). RESULTS: Patients with metastatic-PC and IDC-P (Group 1), the pooled HR for CFS and OS were 1.69 (95% Confidence Interval (CI): 1.30-2.21) and 2.00 (95% CI: 1.38-2.91), respectively. In group 2a, BRF and CSS, patients with IDC-P had high HR 2.63 (95% CI: 1.99-3.49) and 2.87 (95% CI: 1.65-5.01), respectively. Likewise, IDC-P in group 2b patients demonstrated a HR of 2.04 (95% CI: 1.10-3.78) for BRFS. CONCLUSIONS: Patients with IDC-P demonstrated poorer outcomes including lower BRF following radical prostatectomy, radiation therapy either in primary and salvage settings than in the patients without IDC-P. In addition, metastatic-PC patients with IDC-P had shorter time to progression to castration-resistance and poor OS as compared with localized PC. Our analysis and review of the literature suggest that IDC-P may be used as prognostic and predictive morphological evidence to influence clinical management in men with PC including pelvic lymph node dissection and pelvic radiotherapy. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e947-e947 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jatinder Kumar* More articles by this author Shiva Gautam More articles by this author Daniel Norez More articles by this author Muhhamad Alam More articles by this author Karthik Tanneru More articles by this author Soroush Bazargani More articles by this author Syed Behzaad Jazayeri More articles by this author Hariharan Palayapalayam Ganapathi More articles by this author Mark Bandyk More articles by this author Joseph Costa More articles by this author Shahriar Koochekpour More articles by this author KC Balaji More articles by this author Expand All Advertisement PDF downloadLoading ...