Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
Department of Urology, Affiliated Hospital of Zunyi Medical University, Guizhou, China.
Prostate. 2019 Oct;79(14):1673-1682. doi: 10.1002/pros.23892. Epub 2019 Aug 21.
The prognostic value of ductal adenocarcinoma of the prostate (DA) in nonmetastatic prostate cancer (PCa) has been identified in many studies. However, it remains unknown whether DA is an adverse prognostic factor in metastatic PCa (mPCa).
Data from 634 mPCa patients histopathologically documented with DA or/and acinar adenocarcinoma of the prostate in our center between 2012 and 2018 were retrospectively analyzed. Propensity score matching (PSM) was used to balance the baseline features. Data from the Surveillance, Epidemiology, and End Results (SEER) database were utilized to validate our findings. Castration-resistant PCa-free survival (CFS), overall survival (OS), and cancer-specific survival (CSS) were set as endpoints.
DA was confirmed in 35 of 634 (5.5%) patients. Among the DA-positive patients, 7 of 35 (20%) and 28 of 35 (80%) harbored high (DA ≥ 50%) and low (DA < 50%) DA components, respectively. DA was not associated with poorer median CFS (mCFS) or median OS (mOS) either before PSM (mCFS: 16.9 vs 18.4 month, P = .814; mOS: 42.0 vs 70.1 month, P = .796) or after PSM (mCFS: 16.9 vs 16.9 month, P = .949; mOS: 42.0 vs 79.9 month, P = .960). Likewise, in the SEER data, DA-positive patients (n = 15 153) shared similar median CSS (25.0 vs 28.0 month, P = .206) and OS (26.0 vs 35.0 month, P = .095) with DA-negative patients (n = 70). No prognostic difference was found between patients with high and low DA components.
We conducted the first study investigating the prognostic value of DA in de novo mPCa. DA was not associated with adverse clinical outcomes in mPCa patients. These findings are helpful for prognostic evaluation, treatment decision making and counseling in mPCa patients.
在许多研究中，前列腺导管腺癌（DA）在非转移性前列腺癌（PCa）中的预后价值已得到确定。然而，尚不清楚 DA 是否是转移性 PCa（mPCa）的不良预后因素。
回顾性分析了 2012 年至 2018 年期间在我们中心组织学证实为 DA 或/和前列腺腺癌的 634 例 mPCa 患者的数据。使用倾向评分匹配（PSM）来平衡基线特征。利用监测、流行病学和最终结果（SEER）数据库的数据来验证我们的发现。无去势抵抗性前列腺癌生存（CFS）、总生存（OS）和癌症特异性生存（CSS）作为终点。
在 634 例患者中，35 例（5.5%）确诊为 DA。在 DA 阳性患者中，7 例（20%）和 28 例（80%）分别具有高（DA≥50%）和低（DA<50%）DA 成分。PSM 前后，DA 均与更差的中位 CFS（mCFS）或中位 OS（mOS）无关（mCFS：16.9 与 18.4 个月，P=0.814；mOS：42.0 与 70.1 个月，P=0.796）。同样，在 SEER 数据中，DA 阳性患者（n=15153）与 DA 阴性患者（n=70）的中位 CSS（25.0 与 28.0 个月，P=0.206）和 OS（26.0 与 35.0 个月，P=0.095）相似。高 DA 成分和低 DA 成分患者之间未发现预后差异。
我们进行了第一项研究，以调查 DA 在初发 mPCa 中的预后价值。DA 与 mPCa 患者的不良临床结局无关。这些发现有助于 mPCa 患者的预后评估、治疗决策制定和咨询。
