Prostatic Duct Adenocarcinoma: Clinical Characteristics, Treatment Options, and Outcomes - a Rare Cancer Network Study

Background: To evaluate the clinical characteristics, contemporary treatment options, and outcome of prostatic duct adenocarcinoma (PDA), we initiated a Rare Cancer Network (RCN) study. Materials and Methods: Six member institutions of the RCN collected clinical data on 31 patients. Treatment consisted of definitive radiotherapy in 14 patients and radical prostatectomy in 16 patients. One patient was treated with androgen deprivation alone. The mean follow-up period was 56 months. Results: Of the 14 patients managed with radiotherapy, 1 patient developed bone metastases and died of prostate cancer, and 1 patient had a biochemical relapse 8 years after definitive radiotherapy. Of the 16 patients who underwent radical prostatectomy, 2 patients developed bone metastases, one of who died of disease. Three patients that relapsed after prostatectomy were successfully salvaged with radiotherapy. The patient that was treated with androgen deprivation alone developed bone metastases at 10 months, was treated with chemotherapy, and was alive after 22 months. Conclusions: Our results suggest that PDA is a cancer with a behavior similar to that of high Gleason grade acinar carcinoma. Good local control can be achieved by either radiation or surgery. Postoperative radiotherapy seems to work as an adjuvant or salvage treatment, and most tumors appear to respond to androgen deprivation