Perhaps you can explain more about
this for me. My understanding of the cribriform pattern comes from the ISUP Consensus on Gleason Grading:
2014 ISUP Consensus Statement said...
A major point of divergence from the original Gleason system is with the assignment of grade to cribriform glands. Within Gleason’s original illustrations of his cribriform pattern 3, he depicts large cribriform glands.Cases graded prior to 2005 as Gleason pattern 3 included large cribriform glands that today would uniformly be called Gleason pattern 4. It was agreed in the 2005 consensus that the vast majority of cribriform patterns be diagnosed as Gleason pattern 4, with only rare cribriform lesions satisfying diagnostic criteria for cribriform pattern 3. However, at the 2005 conference, when various images of these rare candidates for cribriform Gleason pattern 3 were shown to the participants of the consensus meeting, almost none of them were uniformly accepted as cribriform pattern 3 based on subtle features. A subsequent study, led by one of the current authors and published in 2008, found that even in a highly selected set of images thought to be the best candidates for cribriform pattern 3, most experts interpreted the cribriform patterns as pattern 4.The authors of this study concluded that all cribriform structures should be interpreted as Gleason pattern 4 and not pattern 3. This was formally accepted in the 2014 consensus conference, based both on the poor interobserver reproducibility of experts in diagnosing cribriform Gleason pattern 3 cancer and subsequent numerous studies demonstrating that cribriform glands, regardless of morphology, were associat- ed with an adverse prognosis.
So, I understood from this that cribriform patterns were moved from Grade 3 to Grade 4 since 2005. This makes both Grade 3 and Grade 4 less
risky than they were before 2005 (this is called the Will Rogers Effect). In other words, before 2005, your GS 3+4 cores might have been graded as GS 3+3. But now, because they are cribriform, they are deemed as GS 3+4 instead. Your cancer isn't more risky, it's less risky.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
•SBRT 9 yr onc. results
•SBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEsmy PC blog