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In a subset analysis of cases with Grade Group 2 (Gleason score 3+4, n=208), these associations did not reach statistical significance, but the presence of cribriform growth in this subgroup showed a trend towards increased upgrading to Grade Group 5 (Gleason score 9/1 (1 (0.5%) vs. 5 (2.4%)), P=0.06). This large prospective study comparing biopsy and prostatectomy finding of cribriform architecture demonstrates that cribriform pattern 4 is associated with adverse prognostic features and highlights the relevance for recognizing specif