Morphological features of acute appendicitis in elderly patients

Background & Objectives: Although the presence of intraductal carcinoma of the prostate (IDC-P) influences biochemical failure in radical prostatectomy patients, no data are available regarding the impact of its integration into the classification Grade Group system. Thus, the aim of this study was to enhance the utility of the Grade Group (GG) system by integrating the presence of IDC-P. Methods: This study was a retrospective evaluation of 1019 patients with prostate cancer who underwent radical prostatectomy between 2005 and 2013 without neoadjuvant or adjuvant therapy. Data on age, prostatespecific antigen (PSA) level at diagnosis, pathological T stage (pT), the presence of Gleason pattern 5 (GP5), the presence of IDC-P, and surgical margin status were analysed to predict PSA recurrence after prostatectomy. Results: IDC-P was detected in 157 patients (15.4%). GGs were as follows: GG1 without IDC-P, n=163; GG2 without IDC-P, n=470; GG3 without IDC-P, n=160; GG4 without IDC-P, n=27; GG5 without IDC-P, n=42; any GG with IDC-P, [n=157; GG 2 (n=29); GG3 (n=60); GG4 (n=13); GG5 (n=55)]. Any GG with IDC-P showed a significantly worse prognosis than any other GG without IDC-P (p< 0.0001). In a multivariate analysis, integration of the IDC-P into the GGs was significant prognostic predictors (P < 0.0001). Conclusion: Integrating the presence of IDC-P into the GG system will result in more accurate predictions of patient outcome.