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Cancers
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Intraductal Cancer of the Prostate (IDC-P): Diagnosis and Characterization
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Intraductal Cancer of the Prostate (IDC-P): Diagnosis and Characterization

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 11552

Special Issue Editor

Prof. Dr. Eva M. Comperat

E-Mail Website
Guest Editor
Department of Pathology, General Hospital, Medical University Vienna, 1090 Vienna, Austria
Interests: uropathology; development of bladder cancer; prostate cancer

Special Issue Information

Dear Colleagues,

IDC-P is complicated to recognize; it is considered an intra-acinar and/or intraductal neoplastic epithelial proliferation that exhibits more important architectural and/or cytologic atypia than high-grade prostatic intraepithelial neoplasia (PIN). It is considered a distinct entity in the 2016 WHO classification of tumors of the prostate, and occupies an important chapter in the new WHO 2022 classification.

Pathologists now have a better knowledge of the IDC-P, and this entity has also started to make its way toward clinicians. Nevertheless, much research and teaching still have to be undertaken in order to recognize and report this type of tumor in the correct way. Recognizing IDC-P can be extremely challenging, and in cases of no invasive tumor, it is of major interest to recognize IDC-P. Recommendations are therefore that IDC-P should be reported in prostatectomies and especially in prostate biopsies if no invasive prostate cancer is seen, and it is important to perform basal cell immunostains on biopsy and RP to identify IDC-P.

According to GUPS, IDC-P should not be included in determining the final Gleason score/grade group on prostate biopsies and/or RP.

Several studies have shown that ICD-P has a negative impact on the patient’s outcome, and that these lesions must be reported in the pathology report, as it is not recommended to include patients with IDC-P in active surveillance programs.

Prof. Dr. Eva M. Comperat
Guest Editor

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Keywords

  • atypical aspects of IDC-P
  • prognosis
  • diagnosis
  • recommendations
  • treatment

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Published Papers (5 papers)

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Review

10 pages, 4240 KiB  
Review
Cribriform versus Intraductal: How to Determine the Difference
by Eva Compérat, Johannes Kläger, Nathalie Rioux-Leclercq, André Oszwald and Gabriel Wasinger
Cancers 2024, 16(11), 2002; https://doi.org/10.3390/cancers16112002 - 24 May 2024
Viewed by 2207
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Intraductal Cancer of the Prostate (IDC-P): Diagnosis and Characterization)
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9 pages, 589 KiB  
Review
Clinical Management of Intraductal Carcinoma of the Prostate
by Gabriel Wasinger, Olivier Cussenot and Eva Compérat
Cancers 2024, 16(9), 1650; https://doi.org/10.3390/cancers16091650 - 25 Apr 2024
Viewed by 2393
Abstract
Intraductal carcinoma of the prostate (IDC-P) has emerged as a distinct entity with significant clinical implications in prostate cancer (PCa) management. Despite historically being considered an extension of invasive PCa, IDC-P shows unique biological characteristics that challenge traditional diagnostic and therapeutic settings. This [...] Read more.
Intraductal carcinoma of the prostate (IDC-P) has emerged as a distinct entity with significant clinical implications in prostate cancer (PCa) management. Despite historically being considered an extension of invasive PCa, IDC-P shows unique biological characteristics that challenge traditional diagnostic and therapeutic settings. This review explores the clinical management of IDC-P. While the diagnosis of IDC-P relies on specific morphological criteria, its detection remains challenging due to inter-observer variability. Emerging evidence underscores the association of IDC-P with aggressive disease and poor clinical outcomes across various PCa stages. However, standardized management guidelines for IDC-P are lacking. Recent studies suggest considering adjuvant and neoadjuvant therapies in specific patient cohorts to improve outcomes and tailor treatment strategies based on the IDC-P status. However, the current level of evidence regarding this is low. Moving forward, a deeper understanding of the pathogenesis of IDC-P and its interaction with conventional PCa subtypes is crucial for refining risk stratification and therapeutic interventions. Full article
(This article belongs to the Special Issue Intraductal Cancer of the Prostate (IDC-P): Diagnosis and Characterization)
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17 pages, 10357 KiB  
Review
Intraductal Carcinoma of the Prostate versus Simulants: A Differential Diagnosis Growing in Clinical Impact
by Steven Christopher Smith and Sara E. Wobker
Cancers 2024, 16(6), 1097; https://doi.org/10.3390/cancers16061097 - 8 Mar 2024
Viewed by 2322
Abstract
Despite its first recognition even longer ago, in the past nearly 20 years, intraductal carcinoma of the prostate has become a standard histopathologic reporting parameter conveying a strong negative prognostic factor for prostatic adenocarcinoma. When seen at biopsy, intraductal carcinoma of the prostate [...] Read more.
Despite its first recognition even longer ago, in the past nearly 20 years, intraductal carcinoma of the prostate has become a standard histopathologic reporting parameter conveying a strong negative prognostic factor for prostatic adenocarcinoma. When seen at biopsy, intraductal carcinoma of the prostate is associated with risk for aggressive prostatectomy outcomes, including frequently high-grade, high-stage, high-volume disease, with increased risk for recurrence and progression. Multiple organizations, including the uropathology subspecialty societies to the World Health Organization, recognize and recommend reporting the presence of intraductal carcinoma, whether sampled in “pure” form or present with concomitant invasive adenocarcinoma. Moreover, emerging scholarship relates intraductal carcinoma to higher prevalence of homologous recombination repair deficiency mutations in prostatic adenocarcinoma, whether somatic or germline, which serve as indications for approved targeted therapies. Taken together, this is a diagnosis for the histopathologist not to miss. In view of these elevated stakes and the opportunity to further precision medicine, this review details neoplastic and non-neoplastic simulants in the differential diagnosis of intraductal carcinoma of the prostate. Full article
(This article belongs to the Special Issue Intraductal Cancer of the Prostate (IDC-P): Diagnosis and Characterization)
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10 pages, 608 KiB  
Review
Molecular Alterations in Intraductal Carcinoma of the Prostate
by Marit Bernhardt and Glen Kristiansen
Cancers 2023, 15(23), 5512; https://doi.org/10.3390/cancers15235512 - 22 Nov 2023
Cited by 4 | Viewed by 1549
Abstract
Intraductal carcinoma of the prostate is most commonly associated with high-grade invasive prostate cancer. However, isolated IDC-P without adjacent cancer or high-grade cancer is also well known. Common genetic alterations present in IDC-P with adjacent high-grade prostate cancer are those described in high-grade [...] Read more.
Intraductal carcinoma of the prostate is most commonly associated with high-grade invasive prostate cancer. However, isolated IDC-P without adjacent cancer or high-grade cancer is also well known. Common genetic alterations present in IDC-P with adjacent high-grade prostate cancer are those described in high-grade tumors, such as PTEN loss (69–84%). In addition, the rate of LOH involving TP53 and RB1 is significantly higher. IDC-P is common in the TCGA molecular subset of SPOP mutant cancers, and the presence of SPOP mutations are more likely in IDC-P bearing tumors. IDC-P without adjacent high-grade cancers are by far less common. They are less likely to have PTEN loss (47%) and rarely harbor an ERG fusion (7%). Molecular alterations that may predispose a person to the development of IDC-P include the loss of BRCA2 and PTEN as well as mutations in SPOP. However, the causative nature of these genetic alterations is yet to be validated. Full article
(This article belongs to the Special Issue Intraductal Cancer of the Prostate (IDC-P): Diagnosis and Characterization)
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15 pages, 7647 KiB  
Review
Intraductal Carcinoma of the Prostate: To Grade or Not to Grade
by Jerasit Surintrspanont and Ming Zhou
Cancers 2023, 15(22), 5319; https://doi.org/10.3390/cancers15225319 - 7 Nov 2023
Cited by 2 | Viewed by 2563
Abstract
Intraductal carcinoma of the prostate (IDC-P) is a distinct tumor type characterized by an expansile growth of atypical glandular epithelial cells within pre-existing prostate glands and ducts and has significant implications on clinical outcomes and patient management. There is an agreement that isolated [...] Read more.
Intraductal carcinoma of the prostate (IDC-P) is a distinct tumor type characterized by an expansile growth of atypical glandular epithelial cells within pre-existing prostate glands and ducts and has significant implications on clinical outcomes and patient management. There is an agreement that isolated IDC-P should not be graded, and IDC-P should be reported with a comment on its clinical significance. However, whether IDC-P should be factored into Grade Group (GG) in the presence of concurrent prostate cancer (PCa) has been debated vigorously. The contradicting opinions were promulgated when the Genitourinary Pathology Society (GUPS) and the International Society of Urological Pathologists (ISUP) published their recommendations for this issue. When IDC-P is present with PCa, the ISUP recommends incorporating it in the GG for the entire case, whereas the GUPS recommends excluding it from the final GG. Consequently, pathologists and clinicians are faced with the conundrum of conflicting recommendations. In this review article, the authors evaluate the magnitude of discrepant GG between the two grading methods, explore the rationales behind the differing views of the two urological societies, present the current reporting practices for IDC-P, and propose a provisional and pragmatic guide to alleviate the dilemma of which recommendation to follow. Full article
(This article belongs to the Special Issue Intraductal Cancer of the Prostate (IDC-P): Diagnosis and Characterization)
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