LAUSR

With more than 1.2 million cases worldwide reported in 2018, prostate cancer is one of the most frequently diagnosed malignancies in males [1]. Ductal adenocarcinoma (DAC), a rarer subtype, has been reported in its purest form in 0.2%e1.3% of localised prostate cancers, with 0.8%e 12.7% co-existing with acinar adenocarcinoma, the most common histological type of prostate cancer [2]. Thus, under-recognised forms of prostate cancer can still affect thousands of patients and should not be overlooked. Morphological variants of this common cancer, including DAC and intraductal carcinoma of the prostate (IDC-P), are associated with poor overall survival and progression-free survival outcomes. Tumours often present with a greater Gleason grade, tumour stage, degree of extraprostatic extension, and lymph node involvement [3,4]. The paucity of data on response to different treatment modalities in DAC is explained by the variant’s aggressive nature and low incidence, where recruiting sufficient sample sizes is difficult in order to form accurate conclusions. It is therefore timely that this issue of Asian Journal of Urology includes a report by Liu et al. [5] on the oncological outcomes of patients with DAC of the prostate treated with either radical prostatectomy or radiotherapy. They concluded that radical prostatectomy was associated with better survival outcomes in DAC, when compared to radiotherapy. Interestingly, they also found that those in