Introduction: To investigate the relationship between cribriform pattern (CP) and biochemical recurrence-free (BCR) and metastasis-free survival in surgical margin (SM) positive patients after radical prostatectomy (RP). Methods: The data of 421 patients who underwent RP surgery for prostate cancer (PC) between February 2011 and December 2019 in our clinic were retrospectively analyzed. Ninety-five patients with surgical margin positivity (SMP) were included in the study. Presence of CP in the primary tumor and additional SM parameters (localization, laterality, number, length, presence of CP in (+) SM, Gleason grade (GG)) were examined. Risk factors for BCR were investigated. The primary endpoint of the study was the effect of CP on BCR-free survival, and the secondary endpoint was the effect on metastasis-free survival. Declaration of Helsinki and additional approval was obtained from the Ethics Committee of Cukurova University, Medical Faculty, Adana, Turkey (number of meetings: 125; number of decisions: 81). Results: CP was found in the primary tumor in 44 (46.3%) patients, and in both the primary tumor and (+) SM in 11 (11.6%) patients. In the follow-ups, 30 (31.6%) patients developed BCR and 8 (8.4%) patients developed metastasis. Post-RP Gleason score (GS), pathological tumor stage, and lymph node invasion (LNI) were statistically significantly associated with the presence of CP (p=0.001, p=0.001, and p=0.008, respectively). In multivariate Cox regression analysis, both the presence of CP in the primary tumor (HR=1.84, 95% CI=0.98-3.81; p=0.025) and the presence of CP in (+) SM (HR=1,4, 95 %CI=0.42-4.63; p=0.039) was found to increase BCR statistically significantly. The time to metastasis was statistically significantly shorter in patients with CP (101.3 months vs. 122.9 months; p=0.01). The time to BCR was similar in patients with CP in the primary tumor and those with CP in (+) SM (71.5±7.6 and 78.1±7.6, respectively; p=0.321). Conclusions: CP is associated with poor histopathological outcomes and is an independent histopathological predictor of BCR-free and metastasis-free survival in patients with SMP. SOURCE OF Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
