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Grade group 4 prostate cancer without intraductal carcinoma on biopsy is more likely to be downgraded on prostatectomy than with intraductal carcinoma

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Abstract

In this study, we investigated the association between intraductal carcinoma of the prostate (IDCP) along with several histopathological features on prostate biopsy and downgrading of grade group 4 (GG4) prostate cancer (PCa) in patients with the highest grade tumor of GG4 PCa in at least one core. A total of 29 cases had the highest grade tumor of GG4 PCa and radical prostatectomy performed between 2016 and 2021. IDCP was detected in 11 out of 29 cases on biopsy. The cases without IDCP were more likely to be downgraded on prostatectomy than with IDCP, with statistical significance (88.9% vs 36.4%, p = 0.003). The proportions of the highest-grade tumors by length and cores involved, average numbers of PCa-positive cores, and mean patient’s age did not differ between cases that were downgraded and not downgraded at prostatectomy. Our results suggest that the absence of IDCP on biopsy could be a predictor of downgrading at prostatectomy for patients with the highest grade tumor of GG4 PCa.

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References

  1. Schaeffer E, Srinivas S, Antonarakis ES et al (2021) NCCN guidelines insights: prostate cancer, version 1.2021: featured updates to the NCCN guidelines. J Natl Compr Canc Netw 19:134–143

    Article  CAS  PubMed  Google Scholar 

  2. Mohler JL, Antonarakis ES, Armstrong AJ et al (2019) Prostate cancer, version 2.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 17:479–505

    Article  CAS  PubMed  Google Scholar 

  3. Beckmann K, O’Callaghan M, Vincent A et al (2019) Extent and predictors of grade upgrading and downgrading in an Australian cohort according to the new prostate cancer grade groupings. Asian J Urol 6:321–329

    Article  PubMed  PubMed Central  Google Scholar 

  4. Epstein JI, Feng Z, Trock BJ et al (2012) Upgrading and downgrading of prostate cancer from biopsy to radical prostatectomy: incidence and predictive factors using the modified Gleason grading system and factoring in tertiary grades. Eur Urol 61:1019–1024

    Article  PubMed  PubMed Central  Google Scholar 

  5. Wang S, Ryan Russell J, Drescher M et al (2022) Prostate cancer grade downgrading at time of prostatectomy provides risk-stratification insight into future tumor behavior after prostatectomy. Prostate 82:1520–1528

  6. Ginsburg K, Cole AI, Silverman ME et al (2020) Should all prostate needle biopsy Gleason score 4 + 4 = 8 prostate cancers be high risk? Implications for shared decision-making and patient counselling. Urol Oncol 38(78):e1-78.e6

  7. Ranasinghe W, Reichard CA, Nyame YA et al (2020) Downgrading from biopsy grade group 4 prostate cancer in patients undergoing radical prostatectomy for high or very high risk prostate cancer. J Urol 204:748–753

    Article  PubMed  Google Scholar 

  8. Gansler T, Fedewa S, Qi R et al (2018) Most Gleason 8 biopsies are downgraded at prostatectomy-does 4 + 4 = 7? J Urol 199:706–712

    Article  PubMed  Google Scholar 

  9. Chung DY, Lee JS, Goh HJ et al (2019) Predictive factors and oncologic outcome of downgrade to pathologic Gleason score 6–7 after radical prostatectomy in patients with biopsy Gleason score 8–10. J Clin Med Res 8:438

    Google Scholar 

  10. Qi R, Foo W-C, Ferrandino MN et al (2017) Over half of contemporary clinical Gleason 8 on prostate biopsy are downgraded at radical prostatectomy. Can J Urol 24:8982–8989

    PubMed  Google Scholar 

  11. Epstein JI, Amin MB, Fine SW et al (2021) The 2019 Genitourinary Pathology Society (GUPS) white paper on contemporary grading of prostate cancer. Arch Pathol Lab Med 145:461–493

    Article  PubMed  Google Scholar 

  12. van Leenders GJLH, van der Kwast TH, Grignon DJ et al (2020) The 2019 International Society of Urological Pathology (ISUP) consensus conference on grading of prostatic carcinoma. Am J Surg Pathol 44:e87–e99

    Article  PubMed  PubMed Central  Google Scholar 

  13. Van der Kwast T, Al Daoud N, Collette L et al (2012) Biopsy diagnosis of intraductal carcinoma is prognostic in intermediate and high risk prostate cancer patients treated by radiotherapy. Eur J Cancer 48:1318–1325

    Article  PubMed  Google Scholar 

  14. Trinh VQ, Sirois J, Benzerdjeb N et al (2018) The impact of intraductal carcinoma of the prostate on the site and timing of recurrence and cancer-specific survival. Prostate 78:697–706

    Article  CAS  PubMed  Google Scholar 

  15. Saeter T, Vlatkovic L, Waaler G et al (2017) Intraductal carcinoma of the prostate on diagnostic needle biopsy predicts prostate cancer mortality: a population-based study. Prostate 77:859–865

    Article  CAS  PubMed  Google Scholar 

  16. Guo CC, Epstein JI (2006) Intraductal carcinoma of the prostate on needle biopsy: Histologic features and clinical significance. Mod Pathol 19:1528–1535

    Article  PubMed  Google Scholar 

  17. Zhu S, Zhao J-G, Chen J-R et al (2020) Intraductal carcinoma of the prostate in prostate biopsy samples: correlation with aggressive pathological features after radical prostatectomy and prognostic value in high-risk prostate cancer. Asian J Androl 22:519–525

    Article  PubMed  Google Scholar 

  18. Wenzel M, Würnschimmel C, Chierigo F et al (2021) Nomogram predicting downgrading in national comprehensive cancer network high-risk prostate cancer patients treated with radical prostatectomy. Eur Urol Focus 8:1133–1140

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LT: conceptualization, data curation and analysis, writing—original draft. TC: data curation and analysis, writing—original draft. AK: conceptualization, data curation and analysis, writing—editing. MP: conceptualization, supervision, writing—editing.

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Correspondence to Levent Trabzonlu.

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The authors declare no competing interests.

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This study has been performed in compliance with the institutional ethical standards.

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Trabzonlu, L., Chaiprasit, T., Kontosis, A. et al. Grade group 4 prostate cancer without intraductal carcinoma on biopsy is more likely to be downgraded on prostatectomy than with intraductal carcinoma. Virchows Arch 484, 517–520 (2024). https://doi.org/10.1007/s00428-024-03745-4

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  • DOI: https://doi.org/10.1007/s00428-024-03745-4

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