Prognostic Significance of Cribriform Architecture of Pattern 4 Prostatic Adenocarcinomas

Objective: Among prostate cancer patients, the Gleason score is associated with adverse clinical outcomes. We aimed to determine whether cribriform architecture in prostate cancer patients without a history of treatment was related to prognosis in patients with Gleason pattern 4 of prostate cancer.  Material and Methods: A prospective cross-sectional study included (n=450) consecutive prostate biopsy specimens between June 2014 and May 2015, out of which (n=237) had pattern 4 prostate adenocarcinoma. Demographic, clinical, and follow-up details were obtained. Patients (n = 86) with a treatment history were excluded from the study.  Results: Univariate Cox regression analysis of diagnostic biopsies from (n=151) patients with pattern 4 of prostate cancer who had been followed for an average of 70.3 months demonstrated that the cribriform architecture of prostate cancer with pattern 4 was independently associated with poorer disease-specific survival in biopsies with a hazard ratio (HR) of 3.1, 95% Confidence Interval (CI) of 0.9-10.6, and P value of <0.001.  Conclusion: It is concluded that a cribriform architecture of prostate cancer in biopsies with pattern 4 adenocarcinoma is associated with a lower disease- specific survival rate. Therefore, it is essential to report the presence and percentage of cribriform architecture in patients with pattern 4 prostate cancer.