{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T01:53:33Z","timestamp":1781574813610,"version":"3.54.5"},"reference-count":31,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Cribriform architecture is an adverse Gleason pattern 4 morphology associated with aggressive prostate cancer outcomes. Tertiary Gleason pattern 5, even as a minor component, may also identify tumors with higher-grade biology not fully captured by conventional Grade Group assignment. We examined whether cribriform architecture is associated with tertiary Gleason pattern 5 in patients undergoing radical prostatectomy. Methods: We performed a retrospective cross-sectional study of radical prostatectomy specimens from patients with prostate adenocarcinoma who underwent radical prostatectomy and had available clinicopathologic data. A centralized pathology review of digitized radical prostatectomy slides was used to assess cribriform architecture. Tertiary Gleason pattern 5 status was obtained from original pathology reports. Multivariable logistic regression was used to evaluate the association between cribriform architecture and tertiary Gleason pattern 5 after adjustment for age, preoperative prostate-specific antigen level, prostatectomy Gleason score, pathologic tumor stage, and margin status. Results: Among 303 patients, 47 (15.5%) had tertiary Gleason pattern 5. Cribriform architecture was more common in tumors with tertiary Gleason pattern 5 than in those without (70% vs. 21%; p &lt; 0.001). On multivariable analysis, cribriform architecture remained independently associated with tertiary Gleason pattern 5 (adjusted odds ratio of 9.46; 95% confidence interval of 4.49\u201321.0; p &lt; 0.001). The model demonstrated good discrimination, with an area under the receiver operating characteristic curve of 0.80. Conclusions: Cribriform architecture was strongly associated with tertiary Gleason pattern 5. These findings suggest that cribriform-positive tumors may be more likely to harbor minor high-grade pattern 5 components.<\/jats:p>","DOI":"10.3390\/jcm15124637","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:49:01Z","timestamp":1781570941000},"page":"4637","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Cribriform Architecture and Tertiary Gleason Pattern 5 in Prostate Cancer: A Cross-Sectional Study of Radical Prostatectomy Specimens"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5559-8554","authenticated-orcid":false,"given":"Sayeh","family":"Fattahi","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Brigham and Women\u2019s Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6590-3233","authenticated-orcid":false,"given":"Yetkin","family":"Tuac","sequence":"additional","affiliation":[{"name":"Department of Statistics, Ankara University, Ankara 06100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2884-7243","authenticated-orcid":false,"given":"Okan","family":"Argun","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Brigham and Women\u2019s Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryce","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Brigham and Women\u2019s Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7308-1919","authenticated-orcid":false,"given":"Alicia C.","family":"Smart","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Brigham and Women\u2019s Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fallon E.","family":"Chipidza","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Brigham and Women\u2019s Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan E.","family":"Leeman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Brigham and Women\u2019s Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0101-0951","authenticated-orcid":false,"given":"Mutlay","family":"Sayan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Brigham and Women\u2019s Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1097\/COC.0000000000000308","article-title":"Targeted Prostate Biopsy Gleason Score Heterogeneity and Implications for Risk Stratification","volume":"41","author":"Mesko","year":"2018","journal-title":"Am. 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