The presence of intraductal carcinoma of the prostate is closely associated with poor prognosis:a systematic review and meta-analysis

We aimed to confirm the predictive ability of the presence of intraductal carcinoma of the prostate(IDC-P)for prognosis and the associations between IDC-P and clinicopathological parameters.Studies were identified in PubMed,Cochrane Library,EMBASE,Web of Science,and SCOPUS up to December 1,2019.Hazard ratios(HRs)for survival data and odds ratios for clinicopathological data with 95%confidence intervals(CIs)were extracted.Heterogeneity was evaluated by the I2 value,and quality was assessed by the Newcastle-Ottawa Scale criteria.A total of 4179 patients from 13 studies were included.The results showed that IDC-P presence was significantly associated with poor progression-free survival(PFS;HR=2.31;95%Cl:1.96-2.73),cancer-specific survival(HR=1.89;95%Cl:1.28-2.77),and overall survival(HR=2.14;95%Cl:1.53-3.01).In the subgroup analysis,IDC-P presence was significantly associated with poor PFS in prostate cancer treated by radical prostatectomy(HR=2.48;95%Cl:2.05-3.00)and treated by radiotherapy(HR=2.83;95%Cl:1.65-4.85).Regarding clinicopathological characteristics,patients with IDC-P presence had significantly higher tumor clinical stages,Gleason scores,probabilities of lymph node invasion,positive surgical margins,and positive extraprostatic extension.Our meta-analysis indicates that the presence of IDC-P is closely associated with poor prognosis and adverse clinicopathological characteristics.Our data support the value and clinical utility of the routine detection of IDC-P by pathological examination.These conclusions need further validation,and prospective studies are needed to find better treatment modalities other than traditional first-line therapy for patients with IDC-P.