Abstract
Background: Although extensive research highlights the detrimental effect of cribriform pattern 4 (CP4) on survival in non-high-risk prostate cancer (PC), its prognostic significance in high-risk PC is not well understood. Methods: The individual patient data from the The Cancer Genome Atlas (TCGA) database following radical prostatectomy was retrospectively examined. A predefined statistical analysis was conducted to evaluate the potential association between CP4 and progression-free survival (PFS). Results: Of the 135 patients examined, CP4 was present in 66 (48.9%). Median follow-up was 45.93 months (interquartile range: 22.87, 80.10). Cribriform pattern 4 was associated with a significantly reduced PFS (subdistribution hazard ratio, 1.99; 95% CI, 1.01-3.92; P=.045) following adjustment for covariates. Conclusions: The presence of CP4 in high-risk Gleason 8-10 PC portends worse PFS. Further studies are warranted to fully understand its implications in risk stratification and post-operative management of PC.