Stamey Taylor, Armel Kristen, Ju Andrew W, Chen Shoujun, Navaid Musharraf, Bhatt Arjun, Larkins Michael C
Brody School of Medicine (BSOM), East Carolina University (ECU), 600 Moye Blvd, Greenville, NC, 27834, USA.
Department of Radiation Oncology, ECU, Greenville, NC, USA.
Int Urol Nephrol. 2025 Apr 5. doi: 10.1007/s11255-025-04485-3.
Intraductal carcinoma of the prostate is a rare subset of prostate cancer, for which no consensus treatment guidelines exist. We seek to investigate treatment and survival outcomes for IDC-P in the context of current NCCN guidelines.
The Surveillance, Epidemiology, and End Results (SEER) database was queried to identify patients with intraductal carcinoma of the prostate diagnosed between 2000 and 2020. Cox regression analysis and log-rank comparisons of both overall and cause-specific survival over 5- and 10-year timeframes were conducted.
945 patients were identified. Cox regression analysis demonstrated treatment with unimodal surgery (hazard ratio (HR) = 3.70, p = 0.005) was associated with decreased 10-year cause-specific survival, while unimodal treatment with radiotherapy was associated with decreased 5- and 10-year overall survival (HR = 2.14, p = 0.025; HR = 2.16, p = 0.005, respectively). Univariate survival subanalysis of treatment regimens demonstrated decreased 5-year cause-specific (p = 0.004) and overall (p = 0.019) survival among patients that received only radiotherapy as treatment. Radical prostatectomy alone was non-inferior to radical prostatectomy with adjuvant radiotherapy in the context of 10-year overall survival (90% vs 80%; p = 0.58).
Differences in both 5- and 10-year overall survival and cause-specific survival were present among patients diagnosed with IDC-P. Treatment with unimodal radiotherapy among patients with IDC-P was associated with decreased survival compared to treatment with radical prostatectomy ± adjuvant radiotherapy, while radical prostatectomy alone was non-inferior to radical prostatectomy with adjuvant radiotherapy. Further research into the risk stratification and optimal treatment of these patients is warranted.
前列腺导管内癌是前列腺癌中一种罕见的亚型，目前尚无共识性的治疗指南。我们旨在根据当前的美国国立综合癌症网络（NCCN）指南，研究前列腺导管内癌（IDC-P）的治疗及生存结果。
查询监测、流行病学和最终结果（SEER）数据库，以确定2000年至2020年间诊断为前列腺导管内癌的患者。进行Cox回归分析以及5年和10年时间范围内总生存和特定病因生存的对数秩比较。
共识别出945例患者。Cox回归分析表明，单模式手术治疗（风险比（HR）=3.70，p=0.005）与10年特定病因生存率降低相关，而单模式放射治疗与5年和10年总生存率降低相关（HR分别为2.14，p=0.025；HR为2.16，p=0.005）。治疗方案的单因素生存亚分析显示，仅接受放射治疗的患者5年特定病因生存率（p=0.004）和总生存率（p=0.019）降低。在10年总生存方面，单纯根治性前列腺切除术不劣于辅助放疗的根治性前列腺切除术（90%对80%；p=0.58）。
诊断为IDC-P的患者在5年和10年总生存以及特定病因生存方面存在差异。与根治性前列腺切除术±辅助放疗相比，IDC-P患者接受单模式放射治疗与生存率降低相关，而单纯根治性前列腺切除术不劣于辅助放疗的根治性前列腺切除术。有必要对这些患者的风险分层和最佳治疗进行进一步研究。
