Wasinger Gabriel, Cussenot Olivier, Compérat Eva
Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria.
Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.
Cancers (Basel). 2024 Apr 25;16(9):1650. doi: 10.3390/cancers16091650.
Intraductal carcinoma of the prostate (IDC-P) has emerged as a distinct entity with significant clinical implications in prostate cancer (PCa) management. Despite historically being considered an extension of invasive PCa, IDC-P shows unique biological characteristics that challenge traditional diagnostic and therapeutic settings. This review explores the clinical management of IDC-P. While the diagnosis of IDC-P relies on specific morphological criteria, its detection remains challenging due to inter-observer variability. Emerging evidence underscores the association of IDC-P with aggressive disease and poor clinical outcomes across various PCa stages. However, standardized management guidelines for IDC-P are lacking. Recent studies suggest considering adjuvant and neoadjuvant therapies in specific patient cohorts to improve outcomes and tailor treatment strategies based on the IDC-P status. However, the current level of evidence regarding this is low. Moving forward, a deeper understanding of the pathogenesis of IDC-P and its interaction with conventional PCa subtypes is crucial for refining risk stratification and therapeutic interventions.
前列腺导管内癌（IDC-P）已成为一种独特的实体，在前列腺癌（PCa）管理中具有重要的临床意义。尽管历史上一直被认为是浸润性PCa的一种延伸，但IDC-P显示出独特的生物学特征，对传统的诊断和治疗模式构成挑战。本文综述探讨了IDC-P的临床管理。虽然IDC-P的诊断依赖于特定的形态学标准，但由于观察者间的差异，其检测仍然具有挑战性。新出现的证据强调了IDC-P与不同PCa阶段的侵袭性疾病和不良临床结局之间的关联。然而，目前缺乏针对IDC-P的标准化管理指南。最近的研究建议在特定患者群体中考虑辅助治疗和新辅助治疗，以改善预后并根据IDC-P状态调整治疗策略。然而，目前关于这方面的证据水平较低。展望未来，深入了解IDC-P的发病机制及其与传统PCa亚型的相互作用对于完善风险分层和治疗干预至关重要。
