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AJSP2407 - CME/CMLE - Prognostic significance of i ...
Prognostic significance of invasive cribriform gla ...
Prognostic significance of invasive cribriform gland size and percentage in Gleason score 7 prostate adenocarcinoma
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This study, published in the American Journal of Clinical Pathology, investigates the prognostic significance of invasive cribriform gland size and percentage in Gleason score 7 prostate adenocarcinomas. Cribriform glands are linked with poorer outcomes in prostate cancers, but their specific role in Gleason score 7 cancers was not well understood. The study assessed 177 patients with Grade Group 2 and 3 prostate adenocarcinomas for the presence, percentage, and size of invasive cribriform glands.<br /><br />Key findings include:<br />- Biochemical recurrence-free survival was significantly shorter in cases with cribriform glands larger than 0.5 mm and comprising more than 10% of the tumor.<br />- Larger cribriform gland size and higher proportions were associated with advanced pathological T-stage, higher preoperative prostate-specific antigen levels, lymph node metastasis, and biochemical recurrence.<br />- Cribriform pattern percentage greater than 10% emerged as a key independent predictor of biochemical recurrence.<br /><br />The study suggests that a more aggressive clinical approach may be required for patients with tumors showing large (over 0.5 mm) and extensive cribriform patterns (over 10%). It emphasizes that distinguishing between invasive cribriform glands and intraductal carcinoma is critical, achievable through immunohistochemical staining for basal cells.<br /><br />The findings support the need for treatment strategies in GG 2 and GG 3 prostate cancer cases to incorporate cribriform pattern considerations. While insightful, the study acknowledges its limitations, including a relatively small sample size and short follow-up period, and calls for larger studies to confirm and standardize these findings.
Keywords
prostate adenocarcinoma
Gleason score 7
cribriform glands
biochemical recurrence
prognostic significance
pathological T-stage
prostate-specific antigen
lymph node metastasis
immunohistochemical staining
treatment strategies
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