Mucinous adenocarcinoma of prostate and prostatic adenocarcinoma with mucinous components: a clinicopathological analysis of 143 cases

Abstract

The clinical significance of mucinous prostatic adenocarcinoma remains uncertain. From 6440 cases of prostatic adenocarcinoma treated by radical prostatectomy and reported by Aquesta Uropathology from 2009 to 2014, mucinous components of 5-100% were found in 143 (2.2%). The mean age was 61.4 years, mean preoperative serum was PSA 7.8 ng/mL and clinical stage category was cT1 in 81% and cT2 in 19% of cases. Cases were graded using the 2014 International Society of Urological Pathology recommendation of grading the underlying architecture and Gleason scores were 3+4 in 13.3%, 4+3 in 54.5%, 4+4 in 2.1%, 3+4 or 4+3 both with tertiary 5 in 11.9% and 9-10 in 18.2%. The mucinous component invariably had a high-grade component. Extraprostatic extension was found in 46.8% of cases. In 21.6%, the tumour volume was ≥3 cm³ and 9.7% had surgical margin positivity. Seminal vesicle involvement was found in 6.9%. In 73 cases the mucinous component of the tumour was > 25% and when cases were divided on the basis of the area of mucin present (≤ 25% v > 25%) there was no significant difference between clinical or pathologic features. Similar findings were achieved when cases were compared with a control group of grade-matched non-mucinous carcinoma cases. The 5 year biochemical recurrence (BCR) rates for mucinous vs non-mucinous cancer were 12.5% vs 17% (p=0.15). It was concluded that prostatic adenocarcinoma with mucinous components is often high grade; however, the prognosis appears to be similar to non-mucinous cancers of similar GS.

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