Prognostic Significance of the Cribriform Pattern in Prostate Cancer: Clinical Outcomes and Genomic Alterations.

Given the diverse clinical progression of prostate cancer (PC) and the evolving significance of histopathological factors in its management, this study aimed to explore the impact of cribriform pattern 4 (CP4) on clinical outcomes in PC patients and examine its molecular characteristics.

This retrospective study analyzed data from The Cancer Genome Atlas (TCGA) database and included PC patients who underwent radical prostatectomy (RP) and had pathology slides available for the assessment of CP4. A multivariable competing risk regression analysis was used to assess the association between CP4 and progression-free survival (PFS) while adjusting for established PC prognostic factors. The frequency of genomic alterations was compared between patients with and without CP4 using the Fisher's exact test.

Among the 394 patients analyzed, 129 (32.74%) had CP4. After a median follow-up of 40.50 months (IQR: 23.90, 65.60), the presence of CP4 was significantly associated with lower PFS (AHR, 1.84; 95% CI, 1.08 to 3.114; p = 0.023) after adjusting for covariates. Seven hub genes-KRT13, KRT5, KRT15, COL17A1, KRT14, KRT16, and TP63-had significantly lower mRNA expression levels in patients with CP4 compared to those without.

PC patients with CP4 have distinct genomic alterations and are at a high risk of disease progression following RP. Therefore, these patients may benefit from additional post-RP treatments and should be the subject of a prospective randomized clinical trial.

Cancers. 2024 Mar 22*** epublish ***

Mutlay Sayan, Yetkin Tuac, Mahmut Akgul, Grace K Pratt, Mary D Rowan, Dilara Akbulut, Samet Kucukcolak, Elza Tjio, Shalini Moningi, Jonathan E Leeman, Peter F Orio, Paul L Nguyen, Anthony V D'Amico, Cagdas Aktan

Department of Radiation Oncology, Dana Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215, USA., Department of Statistics, Ankara University, 06100 Ankara, Türkiye., Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY 12208, USA., Center for Cancer Research, Laboratory of Pathology, National Institutes of Health, Bethesda, MD 20892, USA., Department of Pathology and Laboratory Medicine, Rutgers University, New Brunswick, NJ 08901, USA., Histopathology Department, Harrogate District Hospital, Harrogate HG2 7SX, UK., Department of Medical Biology, Faculty of Medicine, Bandirma Onyedi Eylul University, 10250 Balikesir, Türkiye.