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The New Realization About Cribriform Prostate Cancer
Kenneth A Iczkowski1, Gladell P Paner2, Theodorus Van der Kwast3
1Department of Pathology, Medical College of Wisconsin, Milwaukee, WI.
Advances in Anatomic Pathology
|August 19, 2017
Summary
Cribriform pattern in prostate cancer indicates adverse features and outcomes, distinct from other Gleason grades. This finding supports its separate classification and potential revision of the Grade Group system.
Area of Science:
- Uropathology
- Oncology
- Cancer Research
Background:
- The cribriform pattern in invasive prostate cancer has been increasingly recognized.
- Previous studies suggest an association between cribriform patterns and adverse outcomes.
Purpose of the Study:
- To analyze the significance of cribriform patterns in prostate cancer.
- To evaluate the distinct pathologic, outcome, and molecular features of cribriform cancer.
- To propose modifications to the current prostate cancer grading system.
Main Methods:
- Review of data from the past 6 years.
- Analysis of sixteen scientific papers and numerous abstracts.
- Comparative analysis of cribriform versus non-cribriform Gleason grade 4 prostate cancer.
Main Results:
- Any amount of cribriform pattern is linked to adverse pathologic features and poor outcomes.
- Cribriform cancer exhibits distinct pathologic, outcome, and molecular characteristics compared to non-cribriform Gleason grade 4.
- Evidence supports the removal of cribriform cancer from Gleason grade 3.
Conclusions:
- The cribriform pattern represents a distinct biologic entity in prostate cancer.
- Current grading systems may need revision to accurately reflect the prognostic significance of cribriform patterns.
- Recommendations for incorporating cribriform cancer into the 2014 Grade Group scheme are proposed.