Presence of invasive cribriform or intraductal growth at biopsy outperforms percentage grade 4 in predicting outcome of Gleason score 3+4=7 prostate cancer

Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
Charlotte F KweldamGeert Jlh van Leenders

Abstract

Relative increase of grade 4 and presence of invasive cribriform and/or intraductal carcinoma have individually been associated with adverse outcome of Gleason score 7 (GS 7) prostate cancer. The objective of this study was to investigate the relation of Gleason grade 4 tumor percentage (%GG4) and invasive cribriform and/or intraductal carcinoma in GS 3+4=7 prostate cancer biopsies. We reviewed 1031 prostate cancer biopsies from the European Randomized Study of Screening for Prostate Cancer. In total 370 men had G3+4=7. The relation of invasive cribriform and/or intraductal carcinoma and %GG4 with biochemical recurrence-free survival (BCRFS) after radical prostatectomy (n=146) and radiation therapy (n=195) was analyzed using Cox regression. Invasive cribriform and/or intraductal carcinoma occurred in 7/121 (6%) patients with 1-10% GG4, 29/131 (22%) with 10-25%, and 52/118 (44%) with 25-50% GG4 (P<0.001). In crude analysis, both invasive cribriform and/or intraductal carcinoma (HR 2.72; 95% CI: 1.33-5.95; P=0.006) and 10-50% GG4 (HR 2.43; 95% CI: 1.10-5.37; P=0.03) were associated with BCRFS after prostatectomy. In adjusted analysis, invasive cribriform and/or intraductal carcinoma was an independent predictor for BCRFS (HR 2.40...Continue Reading

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Oct 5, 2017·Virchows Archiv : an International Journal of Pathology·Trevor A FloodSusan J Robertson
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Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
Charlotte F KweldamGeert J van Leenders
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Charlotte F KweldamGeert Jlh van Leenders
Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
Charlotte F KweldamGeert Jlh van Leenders
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