Active Monitoring, Surgery, and Radiotherapy for Cribriform-Positive and Cribriform-Negative Prostate Cancer

What is the long-term incidence of metastasis in patients with cribriform-positive and cribriform-negative prostate cancer who undergo active monitoring, surgery, or radiotherapy?In this secondary analysis of the 15-year outcomes of the PROTECT trial, the cumulative incidence of metastasis was 25%, 26%, and 8% for men with cribriform-positive prostate cancer assigned to active monitoring, surgery, and radiotherapy with neoadjuvant androgen deprivation therapy (ADT), respectively. For men with cribriform-negative disease, metastasis occurred in 7%, 4%, and 3% in each group, respectively.These findings suggest that patients with cribriform-negative prostate cancer are at low risk of long-term metastasis regardless of baseline treatment, whereas patients with cribriform-positive prostate cancer are at high risk of metastasis that is potentially reduced in those receiving radiotherapy with neoadjuvant ADT.

Corresponding Author: Nikita Sushentsev, MD, Department of Radiology, University of Cambridge School of Clinical Medicine, Box 218, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom (ns784@medschl.cam.ac.uk).

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