Wu Yu-Peng, Chen Shao-Hao, Wang Shi-Tao, Li Xiao-Dong, Cai Hai, Lin Yun-Zhi, Xue Xue-Yi, Wei Yong, Zheng Qing-Shui, Xu Ning
Department of Urology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
Oncotarget. 2017 Apr 25;8(17):29048-29055. doi: 10.18632/oncotarget.16070.
Infiltrating ductal carcinoma (IDC) is a rare histologic subtype of prostate cancer. We investigated the clinicopathological features and prognosis of IDC compared with acinar cell carcinoma (ACC). We identified 3814 men diagnosed with prostate cancer between 2004 to and 2013 in the Surveillance, Epidemiology, and End Results database, including 511 IDC and 3303 ACC cases. Prostate cancer-specific survival (PCSS) was compared using univariate and multivariate Cox proportional hazards models. Generally, IDC occurred in older men (≥ 65 years old) and presented with larger sizes, and higher grades, American Joint Committee on Cancer (AJCC) stages, AJCC T stages, lymph node positive rates and metastasis rates. Men with IDC were less likely to undergo radical prostatectomy, but more likely to be treated with adjuvant radiation than men with ACC. Five-year PCSS rates were significantly worse in IDC. In the multivariate analysis, patients with ACC had a better PCSS than patients with IDC. In conclusion, IDC has unique clinicopathological characteristics and has worse prognosis than ACC. Multivariable Cox regression analysis showed that age over 85 years, higher grade and T stage, and metastasis at diagnosis were independent prognostic factors of worse survival outcomes, whereas radical prostatectomy was an independent prognostic factor of better survival outcomes.
浸润性导管癌（IDC）是前列腺癌中一种罕见的组织学亚型。我们研究了IDC与腺泡细胞癌（ACC）相比的临床病理特征和预后。我们在监测、流行病学和最终结果数据库中确定了2004年至2013年间被诊断为前列腺癌的3814名男性，其中包括511例IDC和3303例ACC病例。使用单变量和多变量Cox比例风险模型比较前列腺癌特异性生存率（PCSS）。一般来说，IDC发生在老年男性（≥65岁）中，肿瘤体积更大、分级更高、美国癌症联合委员会（AJCC）分期、AJCC T分期、淋巴结阳性率和转移率更高。与ACC患者相比，IDC患者接受根治性前列腺切除术的可能性较小，但接受辅助放疗的可能性更大。IDC患者的5年PCSS率明显更差。在多变量分析中，ACC患者的PCSS优于IDC患者。总之，IDC具有独特的临床病理特征，且预后比ACC更差。多变量Cox回归分析表明，85岁以上、更高的分级和T分期以及诊断时的转移是生存结果较差的独立预后因素，而根治性前列腺切除术是生存结果较好的独立预后因素。
