Cribriform Morphology in Gleason Score 3+4 Moderate-Risk Prostate Cancer: Is it Risk Factor for Biochemical Recurrence?

Arch Esp Urol. 2022 May 28;75(4):325-329. doi: 10.56434/j.arch.esp.urol.20227504.46.

Abstract

Objective: Studies have reported that the cribriform morphology observed in prostate biopsy is associated with increased up-staging, upgrading, positive surgical margins and aggressive prognosis after radical prostatectomy. In our study, we aimed to evaluate the relationship between cribriform morphology and biochemical recurrence in patients with moderate-risk localized PCa with a Gleason score of 3+4 (ISUP grade 2) after radical prostatectomy.

Methods: Datas of 177 patients in the moderate-risk group who were evaluated as ISUP grade 2 after radical prostatectomy were retrospectively evaluated. Patients were divided into 2 groups as without (Group 1) and with biochemical recurrence (Group 2). Age, preoperative PSA level, T stage, follow-up time and presence of cribriform morphology in both groups were evaluated and compared.

Results: The mean preoperative serum total PSA level (group 1: 8.2 ± 3.9 and group 2: 11.9 ± 4.7) and presence of cribriform morphology (group 1: 25 (16%) and group 2: 9 (42%)) was significantly higher in group 2 (p = 0.001 and p = 0.007, respectively). According to the results of univariate and multivariate logistic regression analysis, preoperative serum total PSA level and pres-ence of cribriform morphology were found to be independent risk factors for biochemical recurrence (OR: 4,4; %95 Cl: 1,6-11,7; p=0.003 and OR: 4,7; %95 Cl: 1,7-13,1; p=0,003, respectively).

Conclusion: Cribriform morphology of PCa is a risk factor for biochemical recurrence in patients with moderate risk and GS 3+4. In this respect, individualizing PCa cases accompanied by cribriform morphology from other Gleason Score 3+4 cases seems to be an appropriate approach.

Keywords: cribriform; prostate cancer; recurrence.

MeSH terms

  • Humans
  • Male
  • Neoplasm Grading
  • Neoplasm Recurrence, Local*
  • Prostate-Specific Antigen
  • Prostatectomy / methods
  • Prostatic Neoplasms* / diagnosis
  • Prostatic Neoplasms* / pathology
  • Retrospective Studies
  • Risk Factors

Substances

  • Prostate-Specific Antigen