- Promotor
- Co-promotor
- Date
- Tuesday 11 May 2021, 15:30 - 17:00
- Type
- PhD defence
- Space
- Professor Andries Querido room
- Building
- Education Center
- Location
- Erasmus MC
On Tuesday 11 May 2021, E. Hollemans will defend her PhD dissertation, entitled: ‘The Gleason Score and Beyond; Growth Patterns in Prostate Cancer’.
Prostate cancer is a heterogeneous group of cancer with several histomorphological growth patterns. The Gleason score is the most important pathological parameter for prostate cancer outcome. Men with Gleason score 3+3=6 prostate cancer have excellent outcome and are frequently eligible for active surveillance. Men with Gleason score 3+4=7 or higher generally receive radiation therapy or radical prostatectomy surgery. Despite the urge for active treatment, differences in clinical outcome are observed in intermediate to high risk prostate cancer patients. There is a need for additional parameters to aid risk stratification in these men. Incorporation of individual histopathological growth patterns might be able to support optimal decision-making in this large prostate cancer subpopulation.
In case-control and cohort studies, we investigated histomorphological growth patterns. We focused on cribriform architecture, a patterns previously associated with worse outcome. We studied the effect of intraductal and invasive cribriform carcinoma and its subtypes on outcome in prostate cancer patients. Cribriform architecture overall was associated with shorter biochemical recurrence-free, metastasis-free and disease-specific survival. Especially large cribriform carcinoma has aggressive biological behaviour. Glomerulations may have with cribriform architecture, although this pattern is not associated with worse outcome. In order to incorporate cribriform architecture as predictive parameter, it is essential to detect it in diagnostic biopsies. Biopsy sensitivity for cribriform architecture is unfortunately moderate.
Incorporation of cribriform growth patterns beyond heterogeneous Gleason groups in pathology reporting and clinical decision-making will improve personalized treatment of prostate cancer patients.
Due to corona, the PhD defences do not take place publicly in the usual way in the Senate Hall or in the Professor Andries Querido Room. The candidates will defend their dissertation either in a small group or online.