{
  "abstract": "PurposeTo assess whether follow-up MRI, biopsy status, and timing of cribriform disease detection predict active surveillance (AS) failure in a contemporary transatlantic cohort.\n\nMaterials and Methods.Retrospective MRI-driven AS cohort of 619 men at two academic centers (UK/USA), 2012-2024. Primary outcome: AS failure (disease-specific mortality, metastasis, grade group [GG] [≥]4 progression, or post-treatment biochemical recurrence). Key exposures: final MRI and biopsy status, timing of cribriform [≥]GG2 detection. Cumulative incidence was derived; independent predictors used multivariable Fine-Gray models.\n\nResults.Over median follow-up of 6.4 years, 39/619 men (6%) experienced AS failure. Cribriform [≥]GG2 was detected in 82/619 (13%) on follow-up biopsy versus 24/619 (4%) at baseline, comparably in baseline GG1 (10%) and non-cribriform GG2 (9%), and only in MRI-visible tumors. Three-year AS failure after final biopsy was 31% in men with cribriform [≥]GG2 versus 0-2% with stable or non-cribriform disease; 44% of failures had stable MRI. On Fine-Gray analysis, cribriform [≥]GG2 was the only independent predictor of AS failure in re-biopsied men (SHR 30; 95% CI 5.2-167; P<0.001); no type of MRI progression category was independently predictive. Among 595 men cribriform-negative at baseline, 6-year AS failure after a second biopsy was 34% if cribriform [≥]GG2 was detected versus 7% if still cribriform-negative.\n\nConclusions.Cribriform status at follow-up biopsy independently predicts AS failure, whereas MRI progression does not. The three-fold higher cribriform prevalence at follow-up likely reflects baseline sampling error. Because newly detected cribriform tumours were exclusively MRI-visible, early repeat biopsy of patients with MRI-visible disease may considerably improve risk stratification.",
  "abstract_shown": true,
  "affiliations": [
    "University of California San Diego"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
      "name": "N. Sushentsev"
    },
    {
      "name": "G. Xu"
    },
    {
      "name": "I. G. Li"
    },
    {
      "name": "S. Do"
    },
    {
      "name": "J. Liu"
    },
    {
      "name": "M. Kim"
    },
    {
      "name": "C. Kastner"
    },
    {
      "name": "S. Fernando"
    },
    {
      "name": "A. M. Dale"
    },
    {
      "name": "A. Y. Warren"
    },
    {
      "name": "A. M. Dale"
    },
    {
      "name": "M. Liss"
    },
    {
      "name": "T. Barrett"
    },
    {
      "affs": [
        0
      ],
      "name": "T. M. Seibert"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1eeyn1mayeghk.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.19.26365918",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.19.26365918v1.full",
  "id": "1eeyn1mayeghk",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.19.26365918v1",
  "language": null,
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "urology"
    ],
    [
      "openalex",
      "2740|Prostate Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7223119889",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.19.26365918v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-19",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/1eeyn1mayeghk.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:22Z",
      "native_id": "10.64898/2026.10.19.26365918",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.19.26365918v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:urology",
      "subfield": "general"
    }
  ],
  "title": "Cribriform Status at Follow-up Biopsy Is Critical for Predicting Prostate Cancer Active Surveillance Failure in the MRI Era: a Transatlantic Cohort Study",
  "title_text": "Cribriform Status at Follow-up Biopsy Is Critical for Predicting Prostate Cancer Active Surveillance Failure in the MRI Era: a Transatlantic Cohort Study",
  "type": "preprint",
  "updated_at": "2026-10-30T12:21:22Z",
  "url": "https://research.draconitic.com/paper/1eeyn1mayeghk",
  "venue": "medRxiv",
  "versions": []
}