Faculty Collaboration Database

Comparative influence of cribriform growth and percent Gleason 4 in prostatic biopsies with Gleason 3+4 cancer. Ann Diagn Pathol 2021 Jun;52:151725

Date

02/22/2021

Pubmed ID

33610958

DOI

10.1016/j.anndiagpath.2021.151725

Scopus ID

2-s2.0-85101399112 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

The International Society of Urological Pathology endorses specifying presence of cribriform architecture in Gleason (G)4 prostate cancer because of cribriform's aggressiveness. The relative effect of cribriform presence versus percentage G4 within grade group (GG)2 or 3 was uncertain. 194 men's biopsies with GG2 with or without cribriform (excluding glomeruloid from cribriform) and GG3 without cribriform (controls) from 4 years were reviewed. 173 cases had follow-up including 147 GG2 (15/147 or 10% had cribriform) and 26 GG3. Effects of total tumor specimen involvement, %Gleason 4, and cribriform were stratified into prostatectomy (n = 90), radiotherapy (n = 61), and watching waiting (n = 22) groups. Median follow-up duration was 3.32 years (range 1.90-6.18). Biochemical failures in the above 3 cohorts numbered 9 (9/90; 10%), 5 (5/61; 8%), and 13 (13/22; 59%) respectively. In all groups, (GG2+ GG3, n = 173), the HR for C pattern was 1.64. In GG2, cribriform presence (considering glomeruloid as non-cribriform) conferred a hazard ratio (HR) of 1.51 (p = 0.48). It was 1.38, excluding glomeruloid. In watchful waiting cohort only, presence of C conferred a HR of 2.62 (p = 0.086). All remaining comparisons including percent G4, remained not significant. Thus, only in WW group did cribriform pattern presence approach significance. Detection of differences otherwise was not feasible, probably because: 1) biochemical failure is too rare in GG2 cancer; 2) cribriform frequency was only 10% in GG2 (in current study), less than in higher-grade cancer. 3) Use of biopsy tissue is subject to sampling variation which may undersample cribriform pattern, though biopsy forms the basis of treatment decisions.

Author List

Czaja RC, Tarima S, Wu R, Palagnmonthip W, Iczkowski KA

Authors

Rebecca Claire Czaja MD Instructor in the Pathology department at Medical College of Wisconsin
Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenocarcinoma
Biopsy
Carcinoma, Intraductal, Noninfiltrating
Case-Control Studies
Consensus
Follow-Up Studies
Humans
Male
Neoplasm Grading
Prostate
Prostatectomy
Prostatic Neoplasms
Radiotherapy
Specimen Handling
Watchful Waiting