The Presence of Intraductal Carcinoma of The Prostate Is Closely Correlated with Poor Prognosis: A Systematic Review and Meta-Analysis

Abstract Background We aimed to confirm the predictive ability of the presence of intraductal carcinoma of the prostate (IDC-P) on prognosis and association between IDC-P and clinicopathological parameters.Methods Literatures were identified in PubMed, Cochrane Library, etc. up to December 1st, 2019. Hazard ratio (HR) for survival data and odds ratio (OR) for clinicopathological data with 95% confidence interval (CI) were extracted. Heterogeneity was evaluated by I 2 value and quality assessment by Newcastle-Ottawa Scale (NOS) criteria.Result A total of 4179 patients from 13 studies were included. The results showed IDC-P presence was significantly associated with poor progression-free survival (PFS) (HR = 2.31; 95% CI 1.96 to 2.73), cancer-specific survival (CSS) (HR=1.89; 95% CI 1.28 to 2.77) and overall survival (OS) (HR=2.14; 95% CI 1.53 to 3.01). In subgroup analysis, IDC-P presence was significantly associated with poor PFS in prostate cancer treated by radical prostatectomy (RP) (HR = 2.48; 95% CI 2.05 to 3.00) and those by radiotherapy (RT) (HR=2.83; 95% CI 1.65 to 4.85). For clinicopathological characteristics, IDC-P present patients showed significantly higher tumor clinical stage, Gleason score and probability of lymph node invasive, positive surgical margin and positive extraprostatic extension.Conclusion Our meta-analysis indicates presence of IDC-P is closely correlated with poor prognosis and adverse clinicopathological characteristics. Our data support the value and clinical utility of routine detection of IDC-P by pathological examination. These conclusions need further validation and prospective studies are needed to find better treatment modalities for patients with IDC-P other than traditional first-line androgen deprivation therapy.