Significance of the cribriform pattern in prostatic adenocarcinomas.
BACKGROUND
There is now increased understanding that invasive cribriform carcinoma is a relatively aggressive disease. In some recent publications, the recommendation is that all cribriform patterns be classified as Gleason pattern (GP) 4 rather than GP 3.


METHODS
We assessed the cribriform foci (CF) associated with the more definitive patterns 3, 4, and 5 elsewhere on the 185 radical prostatectomy specimens and evaluated the association of the cribriform pattern with extraprostatic extension, surgical margin.


RESULTS
CF were more frequently observed in cases with definitive patterns 4 and 5 than in cases with pattern 3 (all cases with pattern 5 exhibited CF). Cases with Gleason score 3+3 and CF were more frequently associated with extraprostatic extension, and a positive surgical margin.


CONCLUSIONS
Our results demonstrate that diagnosing all cribriform patterns as at least GP 4 would significantly affect further therapeutic options and prognosis. However, as many of these modifications are empirical and supported by only a few studies, long-term follow-up studies with clinical endpoints are necessary to validate these recommendations.
Pathology Department, Umraniye Education and Research Hospital, Istanbul, Turkey. Electronic address: billurcosan@hotmail.com.
Billur Cosan
BC
Sarbay
Pathology Department, Umraniye Education and Research Hospital, Istanbul, Turkey.
Gozde
G
Kir
Pathology Department, Umraniye Education and Research Hospital, Istanbul, Turkey.
Cumhur Selcuk
CS
Topal
Urology Department, Umraniye Education and Research Hospital, Istanbul, Turkey.
Eyup
E
Gumus
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D001707:Biopsy, Needle; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D011379:Prognosis; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery
Cribriform pattern; Extraprostatic extension; Gleason score; Prostate cancer