Significance of the cribriform pattern in prostatic adenocarcinomas.

INTRODUCTION

There is now increased understanding that invasive cribriform carcinoma is a relatively aggressive disease. In some recent publications, the recommendation is that all cribriform patterns be classified as Gleason pattern (GP) 4 rather than GP 3.

MATERIALS AND METHODS

We assessed the cribriform foci (CF) associated with the more definitive patterns 3, 4, and 5 elsewhere on the 185 radical prostatectomy specimens and evaluated the association of the cribriform pattern with extraprostatic extension, surgical margin.

RESULTS

CF were more frequently observed in cases with definitive patterns 4 and 5 than in cases with pattern 3 (all cases with pattern 5 exhibited CF). Cases with Gleason score 3+3 and CF were more frequently associated with extraprostatic extension, and a positive surgical margin.

CONCLUSIONS

Our results demonstrate that diagnosing all cribriform patterns as at least GP 4 would significantly affect further therapeutic options and prognosis. However, as many of these modifications are empirical and supported by only a few studies, long-term follow-up studies with clinical endpoints are necessary to validate these recommendations.