Molecular risk classifier score and biochemical recurrence risk are associated with cribriform pattern type in Gleason 3+4=7 prostate cancer

Nancy Y. Greenland; Matthew R. Cooperberg; Anthony C. Wong; Emily Chan; Peter R. Carroll; Jeffry P. Simko; Bradley A. Stohr

doi:https://doi.org/10.4111/icu.20210262

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자료유형: 학술저널

저자정보: Nancy Y. Greenland (University of California) Matthew R. Cooperberg (University of California) Anthony C. Wong (University of California) Emily Chan (University of California) Peter R. Carroll (University of California) Jeffry P. Simko (University of California) Bradley A. Stohr (University of California)

저널정보: 대한비뇨기과학회 Investigative and Clinical Urology Investigative and Clinical Urology Vol.63 No.1

발행연도: 2022.1

수록면: 27 - 33 (7page)

DOI: https://doi.org/10.4111/icu.20210262

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Purpose: Among Gleason pattern 4 types, cribriform pattern is associated with the worst outcomes. We hypothesized that larger cribriform patterns would be associated with increased Decipher scores and higher biochemical recurrence (BCR) risk in Gleason 3+4=7 prostatectomy patients. Materials and Methods: The slide from patients who underwent prostatectomy from January 2016 to March 2020 on which Decipher was performed was re-reviewed for Gleason score and cribriform patterns, with large cribriform defined as cribriform acini with greater than 12 lumens and simple cribriform as 12 or fewer lumens. Differences in Decipher score were analyzed in a generalized linear model controlling for pathology stage and tumor margin status. A multivariable Cox proportional hazards model was performed for BCR-free survival. Results: Of 337 cases, 118 were Gleason 3+4=7. The mean Decipher scores in 3+4=7 cases without cribriform, with simple cribriform, and with large cribriform were 0.41, 0.54, and 0.62, respectively. In a multivariable model with pathology stage, margin tumor length, and percentage pattern 4 as covariates, compared to cases without cribriform, simple cribriform was associated with 0.10 increase in Decipher (p=0.03) and 4.7-fold hazard ratio of BCR (95% confidence interval [CI], 0.4?56.5; p=0.22) and large cribriform was associated with 0.17 increase in Decipher (p<0.001) and 16.0-fold hazard ratio of BCR (95% CI, 1.4?181.2; p=0.02). Conclusions: Among Gleason 3+4=7 carcinomas, large cribriform was associated with higher Decipher scores and greater BCR risk. Our results support that large cribriform is an aggressive pattern 4 subtype and should be considered a contraindication for active surveillance.

#Active surveillance #Prostate cancer #Prostatectomy

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