Cribriform Morphology in Gleason Score 3+4 Moderate-Risk Prostate Cancer: Is it Risk Factor for Biochemical Recurrence?

• YAHŞİ, Sedat ^[1] ; CEYLAN, Cavit ^[1] ; KIZILKAN, Yalçın ^[1] ; ŞENEL, Samet ^[1] ; CEVİZ, Kazım ^[1]
  1. [1] Ankara City Hospital, Ankara, Turquía
• Localización: Archivos españoles de urología, ISSN 0004-0614, Tomo 75, Nº. 4 (Mayo), 2022, págs. 325-329
• Idioma: inglés
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• Resumen

  • Objective: Studies have reported that the cribriform morphology observed in prostate biopsy is associated with increased up-staging, upgrading, positive surgical margins and aggressive prognosis after radical prostatectomy. In our study, we aimed to evaluate the relationship between cribriform morphology and biochemical recurrence in patients with moderate-risk localized PCa with a Gleason score of 3+4 (ISUP grade 2) after radical prostatectomy.

    Methods: Datas of 177 patients in the moderate-risk group who were evaluated as ISUP grade 2 after radical prostatectomy were retrospectively evaluated. Patients were divided into 2 groups as without (Group 1) and with biochemical recurrence (Group 2). Age, preoperative PSA level, T stage, follow-up time and presence of cribriform morphology in both groups were evaluated and compared.

    Results: The mean preoperative serum total PSA level (group 1: 8.2 ± 3.9 and group 2: 11.9 ± 4.7) and presence of cribriform morphology (group 1: 25 (16%) and group 2: 9 (42%)) was significantly higher in group 2 (p = 0.001 and p = 0.007, respectively). According to the results of univariate and multivariate logistic regression analysis, preoperative serum total PSA level and pres-ence of cribriform morphology were found to be independent risk factors for biochemical recurrence (OR: 4,4; %95 Cl: 1,6-11,7; p=0.003 and OR: 4,7; %95 Cl: 1,7-13,1; p=0,003, respectively).

    Conclusion: Cribriform morphology of PCa is a risk factor for biochemical recurrence in patients with moderate risk and GS 3+4. In this respect, individualizing PCa cases accompanied by cribriform morphology from other Gleason Score 3+4 cases seems to be an appropriate approach.