Kosin Med J.  2019 Dec;34(2):95-105. 10.7180/kmj.2019.34.2.95.

Cribriform Pattern at the Surgical Margin is Highly Predictive of Biochemical Recurrence in Patients Undergoing Radical Prostatectomy

Affiliations
  • 1Department of Urology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. hongkooha@naver.com
  • 2Department of Urology, Inje University Busan Paik Hospital, Busan, Korea.
  • 3Department of Pathology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
  • 4Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.

Abstract


OBJECTIVES
We investigated the relationship between cribriform patterns and biochemical recurrence in patients with positive surgical margins after radical prostatectomy.
METHODS
This study was based on radical prostatectomy specimens obtained from 817 patients (165 with margin-positive status) collected at a single center between 2010 and 2016. We retrospectively analyzed and compared body mass index, preoperative prostate-specific antigen, Gleason score, operative methods, postoperative Gleason score, pathological T-stage, tumor percentage involvement, lymphatic and perineural invasion, prostate-specific antigen nadir, location and length of the positive margin, cribriform pattern status, and Gleason grade at the surgical margin in terms of their association with biochemical recurrence. Risk factors for biochemical recurrence were also investigated.
RESULTS
21% (31/146) of surgical margin-positive patients had a cribriform pattern. Nadir prostate-specific antigen, perineural invasion and biochemical recurrence rates were significantly higher in cribriform pattern present group than absent group (P = 0.031, 0.043 and 0.045, respectively). According to the Cox regression model, postoperative Gleason score, tumor percentage involvement, location and length of the positive margin, and the presence of a cribriform pattern at the surgical margin were significant predictive factors of biochemical recurrence (P = 0.022, < 0.001, 0.015, 0.001, and 0.022, respectively). Moreover, the biochemical recurrence risk was approximately 3-fold higher in patients with a cribriform pattern at the surgical margin than in those without (HR: 3.41, 95% CI 1.20-9.70, P = 0.022).
CONCLUSIONS
A cribriform pattern at the surgical margin is a significant predictor of biochemical recurrence in patients who undergo radical prostatectomy.

Keyword

Prostatectomy; Prostate-specific antigen; Prostatic Neoplasms; Recurrence; Surgical margin

MeSH Terms

Body Mass Index
Humans
Neoplasm Grading
Prostate-Specific Antigen
Prostatectomy*
Prostatic Neoplasms
Recurrence*
Retrospective Studies
Risk Factors
Prostate-Specific Antigen
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