EURURO Vol. 72 No. 4

Platinum Priority – Brief Correspondence

Editorial by Melvin L.K. Chua, Theodorus H. van der Kwast and Robert G. Bristow on pp. 496–498 of this issue

Systematic Review Links the Prevalence of Intraductal Carcinoma

of the Prostate to Prostate Cancer Risk Categories

Laura H. Porter

a , b , y

, Mitchell G. Lawrence

a , b ,

, Dragan Ilic

c ,

David Clouston

d ,

Damien M. Bolton

e , f ,

Mark Frydenberg

a , g ,

Declan G. Murphy

h , i , j , * ,

Carmel Pezaro

a , k , y

Gail P. Risbridger

a , b , y

, Renea A. Taylor

a , b , l , y , **

Department of Anatomy and Developmental Biology, Biomedicine Discovery Institute, Monash University, Melbourne, Australia;

Prostate Cancer Research

Program, Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia;

School of Public Health & Preventive Medicine, Monash

University, Melbourne, Australia;

TissuPath, Mount Waverley, Australia;

Department of Urology, Austin Hospital, Melbourne, Australia;

Department of

Surgery, University of Melbourne, Melbourne, Australia;

Department of Surgery, Monash University, Melbourne, Australia;

Division of Cancer Surgery,

Peter MacCallum Cancer Centre, Melbourne, Australia;

Australian Prostate Cancer Research Centre, Epworth Healthcare, Richmond, Australia;

Sir Peter

MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia;

Eastern Health Clinical School, Monash University, Melbourne,

Australia;

Department of Physiology, Biomedicine Discovery Institute, Monash University, Melbourne, Australia

E U R O P E A N U R O L O G Y 7 2 ( 2 0 1 7 ) 4 9 2 – 4 9 5

available at

www.scienced irect.com

journal homepage:

www.europeanurology.com

Article info

Article history:

Accepted March 7, 2017

Associate Editor:

Giacomo Novara

Keywords:

BRCA2

germline mutation

Intraductal

Pathology

Prostate cancer

Review

Risk stratification

Abstract

Intraductal carcinoma of the prostate (IDC-P) is associated with poor prognosis. While it is

often regarded as a rare pathology, the prevalence of IDC-P remains unclear, with variable

reports from small and disparate patient populations. To determine how common IDC-P is

across the spectrumof prostate cancer, we conducted a systematic review correlating IDC-

P prevalence with prostate cancer risk. Electronic searches of the OVID Medline, PubMed,

and Scopus literature databases identified 38 patient cohorts in 24 articles, which were

divided between four prostate cancer risk categories (low, moderate, high, and recurrent

or metastatic disease). This review, which included radical prostatectomy and prostate

biopsy specimens from

7000 patients, revealed an unexpectedly high rate of IDC-P. The

IDC-P prevalence increased from 2.1% in low-risk patient cohorts to 23.1%, 36.7%, and

56.0% in moderate-risk, high-risk, and metastatic or recurrent disease risk categories,

respectively (

0.0001). IDC-P was also highly prevalent in tumours following androgen

deprivation therapy or chemotherapy (60%). Contrary to common perceptions, this study

demonstrates a strong association between IDC-P prevalence and aggressive prostate

cancer, with a significantly higher frequency in high-risk disease. Greater recognition and

systematic reporting of IDC-P may improve patient risk stratification.

Patient summary:

Prostate cancer can grow within ducts of the prostate, as well as in

prostate tissue. By reviewing all reports describing prostate cancer growing within

ducts, we found that it occurs more commonly than many scientists and clinicians

appreciate, especially in aggressive prostate cancers. We conclude that there should be

more awareness of this pattern of prostate cancer.

These authors contributed equally to this work.

* Corresponding author. Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria

3000, Australia. Tel. +61 3 94216425; Fax: +61 3 85597379.

E-mail address:

renea.taylor@monash.edu

(R.A. Taylor).

** Co-corresponding author. Department of Physiology, Monash Biomedicine Discovery Institute,

26 Innovation Way, Clayton, Victoria 3800, Australia. Tel. +61 3 99029287; Fax: +61 3 9902 9223.

E-mail address:

declan.murphy@petermac.org

(D.G. Murphy).

http://dx.doi.org/10.1016/j.eururo.2017.03.013

0302-2838/