The following is a summary of “Prognostic value of intraductal carcinoma subtypes and postoperative radiotherapy for localized prostate cancer,” published in the January 2025 issue of Urology by Cao et al. 

Intraductal carcinoma of prostate cancer (IDC-P) is a pathological subtype linked to poor prognosis. It has 2 subtypes: Pattern 1 with sieve-like structures and pattern 2 with solid cribriform structures. 

Researchers conducted a retrospective study to evaluate the impact of IDC-P subtypes on prognosis in patients with localized prostate cancer (PCa) undergoing postoperative radiotherapy (PORT) after radical prostatectomy (RP).  

They conducted a retrospective study of patients with localized PCa treated with RP from August 2013 to December 2020. Inclusion criteria were post-operative PSA <0.1 ng/ml and at least one poor prognostic factor. Patients were grouped by IDC-P status (positive/negative; pattern 1/2) and treatment (RP + PORT or RP only). Kaplan-Meier and Cox regression analyses were used to assess survival, and a nomogram was created to predict recurrence and death probabilities. 

The results showed that 139 patients were included, with a median follow-up of 61.5 months. K-M curves indicated that “IDC-P (+) RP only” had the worst prognosis, while PORT improved survival in patients with IDC-P. Non-intraductal carcinoma patients had a better prognosis. IDC-P (+) pattern 2 was linked to higher biochemical recurrence and death. Multivariate Cox regression revealed pattern 2 as a risk factor for recurrence and death. Other BCR-related risk factors included Gleason grading group 5 (HR=3.343, 95% CI: 1.616–6.916, P=0.001), positive surgical margins (PM) (HR=2.124, 95% CI: 1.044–4.320, P=0.038), and PORT (HR=0.266, 95% CI: 0.109–0.647, P=0.004). OS-related risk factors included grading group 5 (HR=3.642, 95% CI: 1.475–8.991, P=0.005), SVI (HR=2.522, 95% CI: 1.118–5.691, P=0.026), and PORT (HR=0.319, 95% CI: 0.107–0.949, P=0.040). 

Investigators found that IDC-P (+), especially pattern 2, increased the risk of recurrence and death after RP. Postoperative radiotherapy mitigated this risk, suggesting IDC-P as a factor in PORT decisions. 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-025-01690-1