دورية أكاديمية
Comedonecrosis Gleason pattern 5 is associated with worse clinical outcome in operated prostate cancer patients
| العنوان: | Comedonecrosis Gleason pattern 5 is associated with worse clinical outcome in operated prostate cancer patients |
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| المؤلفون: | T. (Tim) Hansum, E. (Eva) Hollemans, EI (Esther) Verhoef, C.H. Bangma, JBW (John) Rietbergen, Susanne Osanto, R. C.M. Pelger, Tom van Wezel, H. G. Van der Poel, Elise Bekers, J (Jozien) Helleman, S. (Sebastiaan) Remmers, G.J.L.H. (Arno) van Leenders |
| المصدر: | Modern Pathology vol. 34 no. 11, pp. 2064-2070 |
| سنة النشر: | 2021 |
| المجموعة: | RePub - Publications from Erasmus University, Rotterdam |
| الوصف: | Individual growth patterns and cribriform architecture are increasingly considered in risk stratification and clinical decision-making in men with prostate cancer. Our objective was to establish the prognostic value of individual Gleason 5 patterns in a radical prostatectomy (RP) cohort. We reviewed 1064 RPs and recorded Grade Group (GG), pT-stage, surgical margin status, Gleason 4 and 5 growth patterns as well as intraductal carcinoma. The clinical endpoints were biochemical recurrence and post-operative distant metastasis. Gleason pattern 5 was present in 339 (31.9%) RPs, of which 47 (4.4%) presented as primary, 166 (15.6%) as secondary, and 126 (11.8%) as tertiary pattern. Single cells/cords were present in 321 (94.7%) tumors with Gleason pattern 5, solid fields in 90 (26.5%), and comedonecrosis in invasive carcinoma in 32 (9.4%) tumors. Solid fields demonstrated either a small nested morphology (n = 50, 14.7%) or medium to large solid fields (n = 61, 18.0%). Cribriform architecture was present in 568 (53.4%) RPs. Medium to large solid fields and comedonecrosis coincided with cribriform architecture in all specimens, and were not observed in cribriform-negative cases. In multivariable analysis adjusted for Prostate-Specific Antigen, pT-stage, GG, surgical margin status and lymph node metastases, cribriform architecture (Hazard Ratio (HR) 9.9; 95% Confidence Interval (CI) 3.9–25.5, P < 0.001) and comedonecrosis (HR 2.1, 95% CI 1.2–3.7, P = 0.01) were independent predictors for metastasis-free survival, while single cells/cords (HR 1.2; 95% CI 0.7–1.8, P = 0.55) and medium to large solid fields (HR 1.6, 95% CI 0.9–2.7, P = 0.09) were not. In conclusion, comedonecrosis in invasive carcinoma is an independent prognostic Gleason 5 pattern for metastasis-free survival after RP. These data support the current recommendations to routinely include cribriform pattern in pathology reports and indicate that comedonecrosis should also be commented on. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| العلاقة: | https://repub.eur.nl/pub/136901Test; urn:hdl:1765/136901 |
| DOI: | 10.1038/s41379-021-00860-4 |
| الإتاحة: | https://doi.org/10.1038/s41379-021-00860-4Test https://repub.eur.nl/pub/136901Test |
| رقم الانضمام: | edsbas.42768510 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1038/s41379-021-00860-4 |
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