Ductal prostate cancer in a Croatian cohort of patients

34 Ductal prostate cancer in a Croatian cohort of patients Pezelj I, Katusic J., Stimac G., Justinic D., Grubisic I., Svagusa I., Ruzic B. Sestre Milosrdnice University Hospital Center, Clinical Department of Urology, Zagreb, Croatia INTRODUCTION & OBJECTIVES: Ductal prostate cancer (DCap) is a rare and aggressive form of prostate cancer first described in 1967 by Melichow and Pachter. It is difficult to diagnose in early stages and difficult to treat. Patients usually have low and often normal PSA values even in later stages of the disease. Because the tumor itself is often located centrally, near the urethra, it is often not palpable during the rectal exam (DRE). DCaP can be found as pure or mixed with adenocarcinoma. Our aim was to examine the characteristics of patients diagnosed with ductal prostate cancer at our department. MATERIAL & METHODS: We reviewed all patients treated for ductal cancer from 2003 to 2014. Data were collected and compared with that of patients treated for prostate adenocarcinoma (ACap) as well as previously published data on DCap. RESULTS: The incidence of DCap in our cohort was 0.53% (n=2093) with a mean age of 69.4 years which is higher than in the ACap group (64.5 years). Average PSA levels for DCap group where 9.1 ng/ml which is lower than the average in the ACap group (11,4 ng/ml ). Patients with a low share of DCap in overall tumor mass (less than 10%) had considerably higher PSA levels (11,04 ng/ml) than patients where the ductal component was more present (7.5 ng/ml). 57.2 % of patients with DCap had T2 disease at the time of diagnosis and 42.8 % had T3 stage. CONCLUSIONS: The incidence of DCap in our cohort of patients is within the previously reported ranges. Patients with DCap are older than patients with ACap and PSA level analysis shows lower PSA levels in patients with mixed form of DCap who have more than 10% of the ductal component. It is very difficult to diagnose DCap in an early stage because of low PSA levels and falsely negative DRE exam results which leads to higher staging at the time of diagnosis. Eur Urol Suppl 2015; 14(6): e1203