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Compérat E, Kläger J, Rioux-Leclercq N, Oszwald A, Wasinger G. Cribriform versus Intraductal: How to Determine the Difference. Cancers (Basel) 2024; 16:2002. [PMID: 38893122 PMCID: PMC11171388 DOI: 10.3390/cancers16112002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Over the years, our understanding of cribriform and intraductal prostate cancer (PCa) has evolved significantly, leading to substantial changes in their classification and clinical management. This review discusses the histopathological disparities between intraductal and cribriform PCa from a diagnostic perspective, aiming to aid pathologists in achieving accurate diagnoses. Furthermore, it discusses the ongoing debate surrounding the different recommendations between ISUP and GUPS, which pose challenges for practicing pathologists and complicates consensus among them. Recent studies have shown promising results in integrating these pathological features into clinical decision-making tools, improving predictions of PCa recurrence, cancer spread, and mortality. Future research efforts should focus on further unraveling the biological backgrounds of these entities and their implications for clinical management to ultimately improve PCa patient outcomes.
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Affiliation(s)
- Eva Compérat
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria
| | - Johannes Kläger
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria
| | | | - André Oszwald
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria
| | - Gabriel Wasinger
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria
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Russo GI, Soeterik T, Puche-Sanz I, Broggi G, Lo Giudice A, De Nunzio C, Lombardo R, Marra G, Gandaglia G. Oncological outcomes of cribriform histology pattern in prostate cancer patients: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2023; 26:646-654. [PMID: 36216967 DOI: 10.1038/s41391-022-00600-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/25/2022] [Accepted: 09/23/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Changes applied to the Prostate cancer (PCa) histopathology grading, where patients with cribriform patterns (CP) may be categorized as grade group 2 and could hypothetically be surveilled. However, CP has been associated with worse oncological outcomes. The aim of our study is to systematically review and meta-analyze the available evidence on CP in PCa patients. METHODS This analysis was registered on PROSPERO (CRD42022298473). We performed a systematic literature search of PubMed, EMBASE and Scopus using Medical Subject Headings (MeSH) indexes, keyword searches, and publication types until December 2021. The search terms included: "prostate", "prostate cancer" and "cribriform". We also searched reference lists of relevant articles. Eligible studies included published journal articles that provided quantitative data on the association between cribriform patterns at radical prostatectomy and the presence of extra-prostatic extension (EPE), seminal vesicle invasion (SVI), positive surgical margins (PSM), biochemical recurrence (BCR) or cancer specific mortality (CSM). RESULTS Overall, 31 studies were included for the quantitative analysis. All articles have been published during a span of 11 years (2011-2022) with a mean month of follow-up of 62.87 months. The mean quality of these studies, assessed with the Newcastle Ottawa Scale was 6.27. We demonstrated that CP was associated with greater risk of EPE (odds ratio [OR] 1.96; P < 0.0001), SVI (OR: 2.89; p < 0.01), and PSM (OR: 1.88; p < 0.0007). Our analyses showed that CP was associated with greater risk of BCR (hazard ratio [HR]: 2.14; p < 0.01) and of CSM (HR: 3.30, p < 0.01). CONCLUSION The presence of CP is associated with adverse pathology at radical prostatectomy and worse biochemical recurrence and cancer specific mortality. These results highlight the importance of a better pathologic report of CP to advise clinician for a strict follow-up in PCa patients.
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Affiliation(s)
| | - Timo Soeterik
- Department of Urology, St Antonius Hospital, Utrecht, The Netherlands
| | - Ignacio Puche-Sanz
- Hospital Universitario Virgen de las Nieves (HUVN). Department of Urology. Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - Giuseppe Broggi
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Catania, Italy
| | | | - Cosimo De Nunzio
- Department of Urology, "Sant'Andrea" Hospital, "La Sapienza" University, Rome, Italy
| | - Riccardo Lombardo
- Department of Urology, "Sant'Andrea" Hospital, "La Sapienza" University, Rome, Italy
| | - Giancarlo Marra
- Department of Surgical Sciences, University of Turin and Città della Salute e della Scienza, Turin, Italy
| | - Giorgio Gandaglia
- Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
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Alasker A, Alghafees M, Chaudhri EN, Al Qurashi AA, Abdul Rab S, Sabbah BN, Musalli Z, Alyami A. An unusually high prevalence of isolated prostatic ductal adenocarcinoma among Saudi patients: A registry-based study. Urol Ann 2023; 15:320-324. [PMID: 37664104 PMCID: PMC10471815 DOI: 10.4103/ua.ua_46_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/07/2023] [Indexed: 09/05/2023] Open
Abstract
Objective We conduct a secondary analysis on the demographics, tumor characteristics, survival, and risk factors for mortality among patients with prostatic ductal adenocarcinoma (PDA) in the Kingdom of Saudi Arabia (KSA). Methods This is a registry-based retrospective study that included all patients diagnosed with prostate cancer in the KSA. The data were collected from the Saudi Cancer Registry, which collects tumor data from all private, military, and health ministry hospitals in Saudi Arabia through five regional offices. Results Among 3607 prostate cancer patients detected during the specified period, 209 (5.8%) had ductal adenocarcinoma. The median interquartile range age of patients was 72.0 years (64.0-78.0). Adenocarcinoma lesions were malignant among all the patients. Grade III tumors were most frequently apparent lesions (61.2%), followed by Grade II tumors (26.3%), Grade I tumors (7.2%), and Grade VI tumors (5.3%). A total of 33 patients died, representing 15.8% of the whole sample. The 1-year survival rate was 78.1%. More than a third of patients who were residing in the Western region deceased (38.0%), whereas no deaths were reported in other regions with a statistically significant difference based on regions (P < 0.001). Conclusion To the best of our knowledge, this is the first registry-based study to investigate PDA in the KSA; these efforts were done to further understand this deadly condition and to further enhance patient care in the KSA.
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Affiliation(s)
- Ahmed Alasker
- Department of Urology, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohammad Alghafees
- Department of Urology, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Eman N. Chaudhri
- Department of Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Abdullah A. Al Qurashi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Saleha Abdul Rab
- Department of Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Belal N. Sabbah
- Department of Medicine, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Ziyad Musalli
- Department of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ali Alyami
- Department of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Ueda T, Fujita K, Nishimoto M, Shiraishi T, Miyashita M, Kayukawa N, Nakamura Y, Sako S, Ogura R, Fujihara A, Minami T, Hongo F, Okihara K, Yoshimura K, Uemura H, Ukimura O. Predictive factors for the efficacy of abiraterone acetate therapy in high-risk metastatic hormone-sensitive prostate cancer patients. World J Urol 2022; 40:2939-2946. [PMID: 36331614 DOI: 10.1007/s00345-022-04200-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE There is a discrepancy in the efficacy of abiraterone acetate for overall survival (OS) in patients with high-risk metastatic hormone-sensitive prostate cancer (mHSPC). This study aimed to identify predictive factors for the efficacy of abiraterone acetate for OS in high-risk mHSPC patients by analyzing them over a longer observation period. METHODS Five hundred high-risk mHSPC patients were retrospectively identified at our hospital and affiliated hospitals in the Kindai Oncology Study Group and Kyoto Prefectural University of Medicine Oncology Study Group between December 2013 and March 2022. Two hundred patients were treated with abiraterone acetate (1000 mg/day) plus prednisolone (5 mg/day) combined with androgen deprivation therapy (ADT). A total of 300 patients were treated with bicalutamide (80 mg/day) in combination with ADT. RESULTS OS was not significantly different between the two treatments in the overall cohort (p = 0.1643). In the subgroup without Gleason pattern 5 at the primary lesion, OS was significantly better in patients treated with abiraterone acetate than in those treated with bicalutamide (p = 0.0192). In the subgroup with Gleason pattern 5 at the primary lesion, no significant difference was found between the two treatments (p = 0.1799). Univariate and multivariate analyses in the subgroup without Gleason pattern 5 at the primary lesion suggested that abiraterone therapy may be an important and independent predictor of OS in high-risk mHSPC patients. CONCLUSION The presence of Gleason pattern 5 at the primary lesion may be a predictor for high-risk mHSPC patients who could benefit from abiraterone acetate treatment.
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Affiliation(s)
- Takashi Ueda
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto-City, Kyoto, 602-8566, Japan.
| | - Kazutoshi Fujita
- Department of Urology, Kindai University, Faculty of Medicine, Sayama-City, Osaka, Japan
| | - Mitsuhisa Nishimoto
- Department of Urology, Kindai University, Faculty of Medicine, Sayama-City, Osaka, Japan
| | - Takumi Shiraishi
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto-City, Kyoto, 602-8566, Japan
| | - Masatsugu Miyashita
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto-City, Kyoto, 602-8566, Japan
| | - Naruhiro Kayukawa
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto-City, Kyoto, 602-8566, Japan
| | - Yuichi Nakamura
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto-City, Kyoto, 602-8566, Japan
| | - Satoshi Sako
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto-City, Kyoto, 602-8566, Japan
| | - Ryota Ogura
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto-City, Kyoto, 602-8566, Japan
| | - Atsuko Fujihara
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto-City, Kyoto, 602-8566, Japan
| | - Takafumi Minami
- Department of Urology, Kindai University, Faculty of Medicine, Sayama-City, Osaka, Japan
| | - Fumiya Hongo
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto-City, Kyoto, 602-8566, Japan
| | - Koji Okihara
- Department of Urology, North Medical Center, Kyoto Prefectural University of Medicine, Yosano-Gun, Kyoto, Japan
| | - Kazuhiro Yoshimura
- Department of Urology, Kindai University, Faculty of Medicine, Sayama-City, Osaka, Japan
| | - Hirotsugu Uemura
- Department of Urology, Kindai University, Faculty of Medicine, Sayama-City, Osaka, Japan
| | - Osamu Ukimura
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto-City, Kyoto, 602-8566, Japan
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Ranasinghe W, Shapiro DD, Zhang M, Bathala T, Navone N, Thompson TC, Broom B, Aparicio A, Tu SM, Tang C, Davis JW, Pisters L, Chapin BF. Optimizing the diagnosis and management of ductal prostate cancer. Nat Rev Urol 2021; 18:337-358. [PMID: 33824525 DOI: 10.1038/s41585-021-00447-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2021] [Indexed: 12/13/2022]
Abstract
Ductal adenocarcinoma (DAC) is the most common variant histological subtype of prostate carcinoma and has an aggressive clinical course. DAC is usually characterized and treated as high-risk prostatic acinar adenocarcinoma (PAC). However, DAC has a different biology to that of acinar disease, which often poses a challenge for both diagnosis and management. DAC can be difficult to identify using conventional diagnostic modalities such as serum PSA levels and multiparametric MRI, and the optimal management for localized DAC is unknown owing to the rarity of the disease. Following definitive therapy for localized disease with radical prostatectomy or radiotherapy, the majority of DACs recur with visceral metastases at low PSA levels. Various systemic therapies that have been shown to be effective in high-risk PAC have limited use in treating DAC. Although current understanding of the biology of DAC is limited, genomic analyses have provided insights into the pathology behind its aggressive behaviour and potential future therapeutic targets.
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Affiliation(s)
- Weranja Ranasinghe
- Department of Urology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
| | - Daniel D Shapiro
- Department of Urology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Miao Zhang
- Department of Pathology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Tharakeswara Bathala
- Department of Radiology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Nora Navone
- Department of Genitourinary Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Timothy C Thompson
- Department of Genitourinary Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Bradley Broom
- Department of Bioinformatics and Computational Biology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Ana Aparicio
- Department of Genitourinary Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Shi-Ming Tu
- Department of Genitourinary Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Chad Tang
- Department of Radiation Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - John W Davis
- Department of Urology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Louis Pisters
- Department of Urology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Brian F Chapin
- Department of Urology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
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Ranasinha N, Omer A, Philippou Y, Harriss E, Davies L, Chow K, Chetta PM, Erickson A, Rajakumar T, Mills IG, Bryant RJ, Hamdy FC, Murphy DG, Loda M, Hovens CM, Corcoran NM, Verrill C, Lamb AD. Ductal adenocarcinoma of the prostate: A systematic review and meta-analysis of incidence, presentation, prognosis, and management. BJUI COMPASS 2021; 2:13-23. [PMID: 35474657 PMCID: PMC8988764 DOI: 10.1002/bco2.60] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/02/2020] [Indexed: 01/22/2023] Open
Abstract
Context Ductal adenocarcinoma (DAC) is relatively rare, but is nonetheless the second most common subtype of prostate cancer. First described in 1967, opinion is still divided regarding its biology, prognosis, and outcome. Objectives To systematically interrogate the literature to clarify the epidemiology, diagnosis, management, progression, and survival statistics of DAC. Materials and methods We conducted a literature search of five medical databases from inception to May 04 2020 according to PRISMA criteria using search terms "prostate ductal adenocarcinoma" OR "endometriod adenocarcinoma of prostate" and variations of each. Results Some 114 studies were eligible for inclusion, presenting 2 907 170 prostate cancer cases, of which 5911 were DAC. [Correction added on 16 January 2021 after the first online publication: the preceding statement has been corrected in this current version.] DAC accounts for 0.17% of prostate cancer on meta-analysis (range 0.0837%-13.4%). The majority of DAC cases were admixed with predominant acinar adenocarcinoma (AAC). Median Prostate Specific Antigen at diagnosis ranged from 4.2 to 9.6 ng/mL in the case series.DAC was more likely to present as T3 (RR1.71; 95%CI 1.53-1.91) and T4 (RR7.56; 95%CI 5.19-11.01) stages, with far higher likelihood of metastatic disease (RR4.62; 95%CI 3.84-5.56; all P-values < .0001), compared to AAC. Common first treatments included surgery (radical prostatectomy (RP) or cystoprostatectomy for select cases) or radiotherapy (RT) for localized disease, and hormonal or chemo-therapy for metastatic disease. Few studies compared RP and RT modalities, and those that did present mixed findings, although cancer-specific survival rates seem worse after RP.Biochemical recurrence rates were increased with DAC compared to AAC. Additionally, DAC metastasized to unusual sites, including penile and peritoneal metastases. Where compared, all studies reported worse survival for DAC compared to AAC. Conclusion When drawing conclusions about DAC it is important to note the heterogenous nature of the data. DAC is often diagnosed incidentally post-treatment, perhaps due to lack of a single, universally applied histopathological definition. As such, DAC is likely underreported in clinical practice and the literature. Poorer prognosis and outcomes for DAC compared to AAC merit further research into genetic composition, evolution, diagnosis, and treatment of this surprisingly common prostate cancer sub-type. Patient summary Ductal prostate cancer is a rare but important form of prostate cancer. This review demonstrates that it tends to be more serious at detection and more likely to spread to unusual parts of the body. Overall survival is worse with this type of prostate cancer and urologists need to be aware of the presence of ductal prostate cancer to alter management decisions and follow-up.
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Affiliation(s)
- Nithesh Ranasinha
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
- Department of UrologyOxford University Hospitals NHS Foundation Trust, Roosevelt DriveOxfordUK
| | - Altan Omer
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
| | - Yiannis Philippou
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
| | - Eli Harriss
- Bodleian Health Care LibrariesUniversity of OxfordOxfordUK
| | - Lucy Davies
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
| | - Ken Chow
- Department of SurgeryRoyal Melbourne HospitalUniversity of MelbourneMelbourneVICAustralia
| | | | - Andrew Erickson
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
| | - Timothy Rajakumar
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
| | - Ian G. Mills
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
| | - Richard J. Bryant
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
- Department of UrologyOxford University Hospitals NHS Foundation Trust, Roosevelt DriveOxfordUK
| | - Freddie C. Hamdy
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
- Department of UrologyOxford University Hospitals NHS Foundation Trust, Roosevelt DriveOxfordUK
| | - Declan G. Murphy
- Division of Cancer SurgeryPeter MacCallum Cancer CentreMelbourneVICAustralia
- Sir Peter MacCallum Department of OncologyUniversity of MelbourneParkvilleVICAustralia
| | - Massimo Loda
- Dana Farber Cancer InstituteHarvardMAUSA
- Weill Cornell Medical SchoolNew YorkNYUSA
| | - Christopher M. Hovens
- Department of SurgeryRoyal Melbourne HospitalUniversity of MelbourneMelbourneVICAustralia
| | - Niall M. Corcoran
- Department of SurgeryRoyal Melbourne HospitalUniversity of MelbourneMelbourneVICAustralia
| | - Clare Verrill
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
- NIHR Oxford Biomedical Research CentreUniversity of Oxford, John Radcliffe HospitalOxfordUK
| | - Alastair D. Lamb
- Nuffield Department of Surgical SciencesUniversity of OxfordOxfordUK
- Department of UrologyOxford University Hospitals NHS Foundation Trust, Roosevelt DriveOxfordUK
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Ranasinghe WKB, Brooks NA, Elsheshtawi MA, Davis JW, Bathala TK, Tang C, Troncoso P, Aparicio A, Tu SM, Pisters LL, Chapin BF. Patterns of metastases of prostatic ductal adenocarcinoma. Cancer 2020; 126:3667-3673. [PMID: 32453443 DOI: 10.1002/cncr.32957] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/22/2020] [Accepted: 03/25/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The current study was conducted to investigate the patterns of metastases in men with metastatic prostatic ductal adenocarcinoma (DAC) and recurrence patterns after therapy. METHODS All patients with a new diagnosis of DAC with de novo metastases and those with localized disease who developed metastases after treatment and were treated at the study institution from January 2005 to November 2018 were included. All patient and tumor characteristics and outcome data were collected. RESULTS A total of 164 patients (37.7%) had metastatic DAC, including 112 with de novo metastases and 52 who developed metastases after treatment. Men with de novo metastases were found to have a significantly higher median prostate-specific antigen level and International Society of Urological Pathology grade but a lower cT3 and/or T4 classification compared with those with metastases that developed after treatment (all P < .05). Approximately 87% of men with de novo metastases progressed despite multiple systemic therapies, 37.6% required intervention for the palliation of symptoms, and 10.1% responded to systemic therapy and underwent treatment of the primary tumor. Men with de novo metastatic DAC and those who developed metastases after treatment had multiple metastatic sites (including bone and viscera), with higher rates of lung metastases noted in the posttreatment group (23.2% vs 44.2%; P = .01). A total of 45 patients who were treated with curative intent developed metastases at a median of 22 months (range, 0.9-74.8 months) after treatment, at low prostate-specific antigen levels (median, 4.4 ng/mL [interquartile range, 1.7-11.1 ng/mL]). CONCLUSIONS The current study described the metastatic patterns of DAC in both patients with de novo metastatic disease and those who later progress to metastases. Men receiving treatment for DAC with curative intent require stringent long-term follow-up with imaging modalities, including chest imaging given the predilection toward lung metastases noted among these patients.
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Affiliation(s)
- Weranja K B Ranasinghe
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Nathan A Brooks
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mohamed A Elsheshtawi
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - John W Davis
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Tharakeswara K Bathala
- Division of Diagnostic Imaging, Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Chad Tang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Patricia Troncoso
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ana Aparicio
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Shi-Ming Tu
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Louis L Pisters
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Brian F Chapin
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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