It remains uncertain if the extent of intraductal carcinoma of the prostate (IDC) exhibiting cribriform (Crib) morphology impacts on patient outcomes. We retrospectively analyzed long-term oncologic outcomes in 182 consecutive radical prostatectomy patients exhibiting Grade Group 2-4 conventional/acinar prostatic adenocarcinoma, along with Crib-IDC but no Gleason grade 5 patterns. A single Crib-IDC focus in the entire prostatectomy specimen was identified in 46 (25.3 %) cases, while others showed 2 (n = 36; 19.8 %), 3 (n = 27; 14.8 %), 4 (n = 11; 6.0 %), or ≥5 (n = 62; 34.1 %) Crib-IDC foci. The maximum Crib-IDC diameter in each case was ≤1-mm (n = 66; 36.3 %), >1/≤2-mm (n = 90; 49.5 %), >2/≤3-mm (n = 21; 11.5 %), or >3-mm (n = 5; 2.7 %). The summed maximum Crib-IDC diameters were ≤1-mm (n = 38; 20.9 %), >1/≤2-mm (n = 39; 21.4 %), >2/≤3-mm (n = 30; 16.5 %), >3/≤4-mm (n = 17; 9.3 %), >4/≤5-mm (n = 9; 4.9 %), or >5-mm (n = 49; 26.9 %). On univariate analyses, the risks of postoperative biochemical recurrence were significantly higher in cases with 3 (P = 0.022) or ≥3 (P < 0.001) Crib-IDCs (vs. 1-2) or ≥4 Crib-IDCs [P < 0.001 (vs. 1-3); P = 0.032 (vs. 3)]. Similarly, the recurrence risk was significantly higher in Crib-IDC cases with the maximum diameter of >1-mm (vs. ≤1-mm; P = 0.002) or the summed diameter of >3-mm (vs. ≤3-mm; P < 0.001). On multivariable Cox regression analyses, 3 [hazard ratio (HR) 2.742, P = 0.016], ≥3 (HR 3.969, P < 0.001), or ≥4 (HR 4.520, P < 0.001) Crib-IDCs (vs. 1-2) and the summed diameter of >3-mm (HR 3.074, P < 0.001) remained significantly predictive of recurrence. Quantitative assessment of Crib-IDC, particularly its number and cumulative diameter on prostatectomy, may thus enhance the postoperative risk stratification of Grade Group 2-4 prostate cancer.
Keywords: Biochemical recurrence; Cribriform morphology; Intraductal carcinoma of the prostate; Prostate cancer; Radical prostatectomy.
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