This general aim of the thesis is to study the clinical relevance, interobserver reproducibility, and genetics of cribriform growth in prostate cancer. More specifically, the aims and outline of this thesis are
• To study the metastatic potential of modified Gleason score 3+3 prostate cancer in radical prostatectomies. (Chapter 2)
• To examine the prognostic value of individual Gleason grade 4 patterns in prostate cancer in radical prostatectomy and diagnostic biopsy specimens. (Chapter 3 and 4)
• To examine whether biopsy Gleason score 3+4 patients without cribriform growth could be candidates for active surveillance by comparing them with Gleason score 3+3 patients. (Chapter 5)
• To study the relation between Gleason grade 4 tumor percentage and cribriform prostate cancer in Gleason score 3+4 biopsies. (Chapter 6)
• To study the reproducibility of various Gleason grade 4 patterns, particularly that of cribriform growth, by undertaking an inter-observer reproducibility study among an international group of genitourinary pathologists. (Chapter 7)
• To study which genetic events are associated with cribriform growth in prostate cancer by using Next Generation Sequencing technology. (Chapter 8)