ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2021
Comedonecrosis Gleason pattern 5 is associated with worse clinical outcome in operated prostate cancer patients.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 21 citations in OpenAlex.
- Radiomics-Based Characterization of Aggressive Prostate Cancer Variants: Diagnostic Challenges and Opportunities.Cancers · 2026Review
- Determinants of oncologic outcomes in high-grade organ-confined prostate cancer after prostatectomy.Histopathology · 2025Article
- Pathologist-like explainable AI for interpretable Gleason grading in prostate cancer.Nature communications · 2025Article
- The tumour histopathology "glossary" for AI developers.PLoS computational biology · 2025Review
- Accelerated growth and local progression of radiorecurrent prostate cancer in an orthotopic bioluminescent mouse model.Scientific reports · 2024Article
- Oral pimonidazole unveils clinicopathologic and epigenetic features of hypoxic tumour aggressiveness in localized prostate cancer.BMC cancer · 2024Article
- Histopathological and Immunohistochemical Characterization of Sebaceous Adenoma and Epithelioma in Dogs.Animals : an open access journal from MDPI · 2024Article
- Intraductal Carcinoma of the Prostate as a Cause of Prostate Cancer Metastasis: A Molecular Portrait.Cancers · 2022Review
- Evaluating the effect of histopathological parameters of prostate adenocarcinoma on prognosis in radical prostatectomy specimens.Annals of Saudi medicineArticle
- Gleason Pattern 5 May Be a Prognostic Factor in Radium-223 Treatment.Cancer diagnosis & prognosisArticle
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13 authors at 4 institutions in 1 country.
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Abstract
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.
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