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Adjuvant Radiation Therapry (ART) vs Early Salvage radiology
Prostate Cancer | Last Active: Aug 27 7:29am | Replies (31)Comment receiving replies
i havent read this one closely, but does it stratify the use of ADT for Cribiform pattern 1 and 2? Many studies dont. It appears Pattern 2 generally doesnt respond well to most drugs/hormones, whereas pattern 1 does in many cases. ps is cribiform pattern 1 the same as IDC-P- and pattern 2 the same as IDC-P+?)
Also, note that it appears abiraterone works better than docetaxel for IDC-P. The study does not discriminate between pattern 1 and pattern 2.
This info comes from this link, which is pretty current. https://www.mdpi.com/2072-6694/16/9/1650#:~:text=Emerging%20evidence%20underscores%20the%20association,risk%20stratification%20and%20therapeutic%20interventions.
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This really is not good news. It’s good that you provided this information, however.
The following makes active surveillance a chancy situation
They found that IDC-P or cribriform patterns occur in 34.3% of men with a Gleason score of 6(3 + 3) at diagnosis following AS, and they hypothesized an underdetection of IDC-P or cribriform lesions upon diagnostic biopsy. Furthermore, they found that the findings from MRI were not predictive factors for the presence of IDC-P or cribriform patterns, suggesting that MRI was not adequate for the detection of these features. These findings seem to imply that in the setting of AS, repeat biopsies are necessary so that significant cancers are not overlooked, which cannot be detected via MRI alone.
Here is another scary part of that article about cribriform
Cribriform pattern 1 refers to benign (non-cancerous) growth that resembles a sieve but lacks the cellular atypia and invasive characteristics of cancer, while Cribriform pattern 2 describes the same cribriform (sieve-like) architectural pattern but with the presence of malignant (cancerous) cells, often with clear evidence of invasiveness or association with intraductal carcinoma of the prostate. While cribriform patterns 1 and 2 are not official Gleason or ISUP grading terms, the presence of a cribriform pattern in prostate tissue is significant because it is a recognized sign of high-grade prostate cancer and is associated with increased risk of recurrence and metastasis.