Prostate cancer with cribriform pattern: Exclusion criterion for active surveillance?

Area of Science:

• Urological Pathology
• Oncology
• Surgical Pathology

Background:

• Cribriform morphology in prostate cancer is increasingly associated with poor prognosis.
• This study investigates the prevalence and clinical associations of cribriform pattern in radical prostatectomy specimens.

Purpose of the Study:

• To describe the presence of cribriform foci in radical prostatectomy specimens.
• To evaluate associations between cribriform pattern and demographic/clinical characteristics.

Main Methods:

• A cohort study of 70 radical retropubic prostatectomy specimens (2012-2016).
• Evaluation of cribriform pattern against age, PSA, biopsy Gleason, post-operative Gleason, extracapsular extension, seminal vesicle invasion, margins, MRI, and radiotherapy.

Main Results:

• Univariable analysis revealed associations between cribriform pattern and PSA recurrence, extracapsular extension, pre-operative PSA, seminal vesicle invasion, and post-operative radiotherapy.
• Significant associations were also found with Gleason 7 on biopsy and Gleason 8/9 in the prostatectomy specimen.

Conclusions:

• Increased pre-operative prostate-specific antigen (PSA) showed a high association with cribriform pattern.
• Further research is required to define specific PSA values linked to cribriform morphology.
• Understanding cribriform pattern aids in identifying aggressive prostate cancer for targeted treatment.