Hi, my husband has IDC and some cribriform in one single core, so I did bunch of reading. IDC, cribriform and PDA are just recently recognized as special entities with different predictive implications. There are a bunch of studies now done but none have definitive answers YET . One thing that is sure is that all have unfavorable effect and that is because those variants have a lot of mutations present and those cells even possibly form self protective micro environments. All in all , there is a study that supports RP and we will follow that study. Of course there are some studies that show no specific benefit of RP but we will choose RP. Why - because those cells often evade standard therapies due to so many mutations so by using pure logic physically eliminating those lesions might help. I mean, what is person to do at this point ? There is consensus that those cohorts of patients need novel approach but no new or personalized protocol exists at this point. The ONLY concrete study that showed definite result was in comparison of different ADT drugs and conclusion was that Abiraterone is superior to Docetaxel as first-line treatment for IDC-P . I am completely new to this murky world of PC so I have zero knowledge about ADT protocols and I hope others will jump here to explain what Abiraterone is and how it differs from regular ADT.
BTW - this study also mentioned that 28% of IDC-P positive cases on needle biopsy were actually IDC-P negative at the time of RP (?!?????). WHAAAAA Somebody just shoot me already ...