Northwestern University, Department of Urology, Chicago, IL, USA.
BJU Int. 2012 Mar;109(6):831-4. doi: 10.1111/j.1464-410X.2011.10520.x. Epub 2011 Aug 24.
To use the national Surveillance, Epidemiology, and End Results (SEER) cancer registry to describe the natural history, national incidence and treatment patterns for ductal prostate cancer (PCa) over the last 20 years, as the available literature on ductal PCa is limited to small case series because of few patient numbers.
From the SEER registry, 693 men with ductal PCa were identified from 1970. The demographics, clinical features and cause of death data were collected from men with ductal and acinar histological types.
The incidence of ductal PCa has increased over each decade, but the overall percentage of ductal relative to acinar PCa has remained stable. Men with ductal PCa were more likely to present with advanced disease (30% T3 with ductal PCa, compared with 7% with acinar PCa). Men with ductal PCa underwent similar rates of radical surgery, lower rates of radiotherapy but a higher frequency of outlet (transurethral resection) procedures. Men with ductal PCa had a significantly greater rate of death from PCa (12% vs 4%) than men with acinar PCa. Comparing PCa-specific mortality, men with ductal PCa had similar rates of death to men with Gleason 4 + 4 grade acinar PCa.
Despite a stable incidence, ductal PCa remains an aggressive PCa usually presenting with advanced clinical stage and resulting in a high rate of PCa-specific mortality similar to Gleason 4 + 4 acinar PCa. Patients would probably benefit from combined modalities including radical surgery, radiotherapy and palliative outlet procedures.
利用国家监测、流行病学和最终结果（SEER）癌症登记处，描述过去 20 年来导管前列腺癌（PCa）的自然史、国家发病率和治疗模式，因为有关导管 PCa 的可用文献仅限于小型病例系列，因为患者人数较少。
从 SEER 登记处，1970 年以来共确定了 693 名患有导管 PCa 的男性。从导管和腺泡组织学类型的男性中收集了人口统计学、临床特征和死亡原因数据。
导管 PCa 的发病率每十年都在增加，但导管相对于腺泡 PCa 的总体百分比保持稳定。患有导管 PCa 的男性更有可能出现晚期疾病（30%的 T3 有导管 PCa，而腺泡 PCa 为 7%）。接受根治性手术的男性比例相似，接受放疗的比例较低，但出口（经尿道切除术）手术的频率较高。患有导管 PCa 的男性死于 PCa 的比率（12%对腺泡 PCa 的 4%）明显高于患有腺泡 PCa 的男性。比较 PCa 特异性死亡率，患有导管 PCa 的男性与 Gleason 4+4 级腺泡 PCa 的男性死亡率相似。
尽管发病率稳定，但导管 PCa 仍然是一种侵袭性的 PCa，通常表现为晚期临床阶段，导致 PCa 特异性死亡率较高，类似于 Gleason 4+4 级腺泡 PCa。患者可能受益于联合治疗模式，包括根治性手术、放疗和姑息性出口手术。
