Mp41-16 Small vs Large Gland Cribriform Morphology on Modern Prostate Biopsy: Differences in Impact on Pathologic and Biochemical Recurrence Outcomes

You have accessJournal of UrologyProstate Cancer: Markers I (MP41)1 May 2024MP41-16 SMALL VS LARGE GLAND CRIBRIFORM MORPHOLOGY ON MODERN PROSTATE BIOPSY: DIFFERENCES IN IMPACT ON PATHOLOGIC AND BIOCHEMICAL RECURRENCE OUTCOMES Andrew M. Wood, Rebecca Campbell, Nour Abdallah, Zaeem Lone, Troy Williams, Prajit Khooblall, Sohan Shah, Ross Liao, Zeyad Schwen, Ruben Olivares, Samuel Haywood, Jesse McKenney, Christopher J. Weight, and Jane Nguyen Andrew M. WoodAndrew M. Wood , Rebecca CampbellRebecca Campbell , Nour AbdallahNour Abdallah , Zaeem LoneZaeem Lone , Troy WilliamsTroy Williams , Prajit KhooblallPrajit Khooblall , Sohan ShahSohan Shah , Ross LiaoRoss Liao , Zeyad SchwenZeyad Schwen , Ruben OlivaresRuben Olivares , Samuel HaywoodSamuel Haywood , Jesse McKenneyJesse McKenney , Christopher J. WeightChristopher J. Weight , and Jane NguyenJane Nguyen View All Author Informationhttps://doi.org/10.1097/01.JU.0001008896.93851.5b.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Invasive cribriform and intraductal carcinoma are histopathologic patterns associated with adverse outcomes in prostate cancer (PCa). While studies on radical prostatectomy (RP) have shown a difference in outcomes between small (SGC) and large gland cribriform (LGC), studies on prostate biopsy have been inconclusive. Our objective was to determine the impact of biopsy LGC versus SGC on adverse pathology and biochemical recurrence (BCR). METHODS: A prospectively maintained RP database was queried for patients with International Society of Urological Pathology (ISUP) grade group (GG) 2 or 3 PCa on preoperative prostate biopsy from 1/2017 to 1/2022. Pathology results were reviewed for cribriform status, as well as other relevant variables. LGC was defined as shortest perpendicular cross-sectional distance >0.25mm. Outcomes included BCR following RP and adverse pathologic features at RP. Hazard ratios for BCR free survival (BCRFS) were calculated using Cox proportional hazards regression. RESULTS: 1009 patients were included in the cohort. Median follow-up time was 19.6 months. Any cribriform pattern on biopsy was found in 317 men (31.4%). 67 (21.1%) contained SGC only. On RP, 659 specimens (65.3%) harbored LGC. 58 (86.6%) of patients with SGC on biopsy harbored LGC on RP. LGC on biopsy was associated with extra prostatic extension (EPE) (p<0.001), seminal vesical invasion (SVI) (p<0.001), lymph node involvement (LNI) (p=0.021), and GG upgrade (p=0.014), while SGC was associated with EPE (p=0.005) but not SVI, LNI, or upgrade. On multivariable analysis, LGC was associated (p<0.001) with worse BCRFS (hazard ratio=2.21, 95% confidence interval=1.40-3.48) as compared with patients within our GG2-3 cohort with no cribriform pattern. Patients with SGC did not have worse BCRFS (p=0.981) when compared to this same group. CONCLUSIONS: Early data suggests that LGC on modern prostate biopsy is associated with more concerning pathologic and biochemical recurrence outcomes compared to SGC. Given that over 85% of patients with SGC on biopsy had LGC on RP, further follow up is needed to obtain an accurate measure of SGC prognostic impact. Small vs large gland cribriform differentiation on biopsy remains an important biomarker with implications for treatment selection. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e680 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Andrew M. Wood More articles by this author Rebecca Campbell More articles by this author Nour Abdallah More articles by this author Zaeem Lone More articles by this author Troy Williams More articles by this author Prajit Khooblall More articles by this author Sohan Shah More articles by this author Ross Liao More articles by this author Zeyad Schwen More articles by this author Ruben Olivares More articles by this author Samuel Haywood More articles by this author Jesse McKenney More articles by this author Christopher J. Weight More articles by this author Jane Nguyen More articles by this author Expand All Advertisement PDF downloadLoading ...