Identification of factors associated with intraductal carcinoma of the prostate.

BACKGROUND

Prostate cancer is a common malignancy. Intraductal carcinoma of the prostate (IDCP) is associated with poor prognosis, but is underreported in certain geographic regions. The presence of IDCP is recently recognized as an independent prognosticatior of poor prognosis. We aim to identify factors associated with IDCP on radical prostatectomy specimens to aid in more accurate diagnosis of IDCP.

METHODS

A retrospective study was conducted on specimens from Showa Medical University Hospital (Japan) and Queen's Medical Center (Hawaii) from April 2020 to March 2024. Clinical data included age, PSA, and race; pathological data included GS, GG, and factors indicated the extent of cancer (EPE, RM, LVI, PNI, SVI). IDCP was diagnosed morphologically; equivocal lesions underwent basal cell IHC. Statistical analyses identified factors associated with IDCP.

RESULTS

Among 279 cases, IDCP was found in 70 (25.1%). The IDCP-positive group had higher PSA levels (14.2 vs. 10.7 ng/ml, p = 0.048). Univariate and Multivariate analyses identified GS (OR: 16.41, p < 0.001), EPE (OR: 2.36, p = 0.02), and PNI(OR: 2.57, p = 0.02) remained independently associated.

CONCLUSION

High grade (GS ≥ 8), EPE, and PNI serve as practical pathological triggers to scrutinize ducts and apply basal-cell IHC, which may reduce under-recognition of IDCP in RP specimens.