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Editorial
Intraductal carcinoma of the prostate: conflicting recommendations confuse clinicians
  1. Murali Varma1,
  2. Daniel M Berney2,
  3. Glen Kristiansen3,
  4. Theodorus H van der Kwast4
  1. 1Cellular Pathology, University Hospital of Wales, Cardiff, UK
  2. 2Centre of Cancer Biomarkers and Biotherapeutics, Queen Mary University of London, London, UK
  3. 3Institute of Pathology, Rheinische Friedrich-Wilhelms-Universitat Bonn, Bonn, Germany
  4. 4Pathology, Laboratory Medicine Program, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Murali Varma; MuraliCardiff{at}gmail.com

https://doi.org/10.1136/jcp-2024-209690

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    Intraductal carcinoma of the prostate (IDCP) generally represents a growth pattern of invasive aggressive acinar prostate cancer but may rarely represent a non-invasive putative precursor of prostate cancer.1 IDCP in needle biopsies may be encountered in isolation or in association with invasive prostate cancer. While there is consensus that pure IDCP in needle biopsies should not be graded, it is controversial whether IDCP associated with invasive cancer should be included in the Gleason score (GS). The International Society of Urological Pathology (ISUP) recommended incorporating the IDCP component into the GS, but the Genitourinary Pathology Society (GUPS) proposed grading only the invasive component with comments on the presence of associated IDCP and its adverse prognostic significance.2 3

    The impact of these conflicting recommendations is greatest in needle biopsies with invasive GS 3+3 and extensive IDCP because such cases would be graded as at least GS 4+3 (grade group 3) based on the ISUP guidelines but GS 3+3 (grade group 1) as per the GUPS recommendation. In this issue, McDonald et al describe such a case where the …

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    Footnotes

    • Handling editor Vikram Deshpande.

    • X @MuraliV72899596

    • Contributors MV wrote the first draft of the paper. Other authors helped to finalise the manuscript. MV is the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests MV is an Associate Editor of the Journal of Clinical Pathology.

    • Provenance and peer review Commissioned; internally peer reviewed.

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