Urology Section, University of Catania, Catania, Italy.
Department of Urology, St Antonius Hospital, Utrecht, The Netherlands.
Prostate Cancer Prostatic Dis. 2023 Dec;26(4):646-654. doi: 10.1038/s41391-022-00600-y. Epub 2022 Oct 10.
Changes applied to the Prostate cancer (PCa) histopathology grading, where patients with cribriform patterns (CP) may be categorized as grade group 2 and could hypothetically be surveilled. However, CP has been associated with worse oncological outcomes. The aim of our study is to systematically review and meta-analyze the available evidence on CP in PCa patients.
This analysis was registered on PROSPERO (CRD42022298473). We performed a systematic literature search of PubMed, EMBASE and Scopus using Medical Subject Headings (MeSH) indexes, keyword searches, and publication types until December 2021. The search terms included: "prostate", "prostate cancer" and "cribriform". We also searched reference lists of relevant articles. Eligible studies included published journal articles that provided quantitative data on the association between cribriform patterns at radical prostatectomy and the presence of extra-prostatic extension (EPE), seminal vesicle invasion (SVI), positive surgical margins (PSM), biochemical recurrence (BCR) or cancer specific mortality (CSM).
Overall, 31 studies were included for the quantitative analysis. All articles have been published during a span of 11 years (2011-2022) with a mean month of follow-up of 62.87 months. The mean quality of these studies, assessed with the Newcastle Ottawa Scale was 6.27. We demonstrated that CP was associated with greater risk of EPE (odds ratio [OR] 1.96; P < 0.0001), SVI (OR: 2.89; p < 0.01), and PSM (OR: 1.88; p < 0.0007). Our analyses showed that CP was associated with greater risk of BCR (hazard ratio [HR]: 2.14; p < 0.01) and of CSM (HR: 3.30, p < 0.01).
The presence of CP is associated with adverse pathology at radical prostatectomy and worse biochemical recurrence and cancer specific mortality. These results highlight the importance of a better pathologic report of CP to advise clinician for a strict follow-up in PCa patients.
前列腺癌（PCa）组织病理学分级发生变化，具有筛状模式（CP）的患者可能被归类为 2 级，并可能被监测。然而，CP 与较差的肿瘤学结果相关。我们研究的目的是系统地回顾和荟萃分析 PCa 患者中 CP 的现有证据。
该分析在 PROSPERO（CRD42022298473）上进行了注册。我们使用医学主题词（MeSH）索引、关键词搜索和出版物类型，在 PubMed、EMBASE 和 Scopus 上进行了系统的文献搜索，直到 2021 年 12 月。搜索词包括：“前列腺”、“前列腺癌”和“筛状”。我们还搜索了相关文章的参考文献列表。符合条件的研究包括提供了根治性前列腺切除术中筛状模式与前列腺外延伸（EPE）、精囊侵犯（SVI）、阳性手术切缘（PSM）、生化复发（BCR）或癌症特异性死亡率（CSM）之间关联的定量数据的已发表期刊文章。
总体而言，有 31 项研究被纳入定量分析。所有文章均在 11 年内（2011-2022 年）发表，平均随访时间为 62.87 个月。使用纽卡斯尔-渥太华量表评估这些研究的平均质量为 6.27。我们表明，CP 与更高的 EPE 风险相关（优势比 [OR] 1.96；P<0.0001）、SVI（OR：2.89；p<0.01）和 PSM（OR：1.88；p<0.0007）。我们的分析表明，CP 与更高的 BCR 风险相关（风险比 [HR] 2.14；p<0.01）和 CSM 风险相关（HR：3.30，p<0.01）。
CP 的存在与根治性前列腺切除术后不良病理相关，并且生化复发和癌症特异性死亡率更高。这些结果强调了更好地报告 CP 的重要性，以便为 PCa 患者的临床医生提供严格的随访建议。
