Gleason pattern 4 with cribriform morphology on biopsy is associated with adverse clinicopathological findings in a prospective radical prostatectomy cohort

Michael Haffner, Daniela C. Salles, Guofeng Gao, Jonathan I. Epstein

Research output: Contribution to journalArticle

Abstract

The prognostic significance of the Gleason grading system has been well established. However, individual Gleason patterns comprise heterogeneous morphologies which might add additional prognostic information. Recent evidence suggests that Gleason pattern 4 with cribriform growth pattern is associated with an adverse prognosis. To determine the association between cribriform pattern on biopsies and pathological findings on subsequent prostatectomies, we evaluated the presence of cribriform architecture in a prospective cohort of 367 men from 2014 to 2018 treated at a single institution. Cribriform architecture was present in 63.5% of all biopsies and was correlated with the overall extent of Gleason pattern 4. In addition, cribriform morphology on biopsy showed a statistically significant association with higher Gleason grade and increased pathological stage and nodal metastasis. In a subset analysis of cases with Grade Group 2 (Gleason score 3 + 4, n = 208), these associations did not reach statistical significance, but the presence of cribriform growth in this subgroup showed a trend toward increased upgrading to Grade Group 5 (Gleason score 9/10) (1 [0.5%] vs. 5 [2.4%], P = 0.06). This large prospective study comparing biopsy and prostatectomy finding of cribriform architecture demonstrates that cribriform pattern 4 is associated with adverse prognostic features and highlights the relevance for recognizing specific morphologies with distinct biological and clinical features.

Original languageEnglish (US)
Pages (from-to)74-80
Number of pages7
JournalHuman pathology
Volume98
DOIs
StatePublished - Apr 2020

Keywords

  • Biopsy
  • Cribriform morphology
  • Gleason pattern
  • Grade Group
  • Prospective study
  • Prostate cancer

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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