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Title: Does perineural invasion in a radical prostatectomy specimen predict biochemical recurrence in men with prostate cancer?
Epworth Authors: Hovens, Christopher
Harewood, Laurence
Peters, Justin
Costello, Anthony
Corcoran, Niall
Other Authors: Reeves, Fairleigh
Battye, Shane
Keywords: Australian Prostate Cancer Research Centre, Epworth HealthCare, Richmond, Australia
Urorenal and Vascular
Prostate Cancer
Perineural Invasion
Radical Prostatectomy
Biochemical Recurrence
Clinically Localized Prostate Cancer
Clinicopathological Factors
Radical Prostatectomy Gleeson Score
PT3 disease
Positive Surgical Margins
Greater Cancer Volume
Prostatic Neoplasms
Issue Date: May-2015
Publisher: PubMed Central
Citation: Can Urol Assoc J. 2015 May-Jun;9(5-6):E252-5
Abstract: INTRODUCTION: The ability of perineural invasion (PNI) in radical prostatectomy (RP) specimens to predict biochemical recurrence (BCR) is unclear. This study investigates this controversial question in a large cohort. METHODS: A retrospective analysis was undertaken of prospectively collected data from 1497 men who underwent RP (no neoadjuvant therapy) for clinically localized prostate cancer. The association of PNI at RP with other clinicopathological parameters was evaluated. The correlation of clinicopathological factors and BCR (defined as prostate-specific antigen [PSA] >0.2 ng/mL) was investigated with univariable and multivariable Cox regression analysis in 1159 men. RESULTS: PNI-positive patients were significantly more likely to have a higher RP Gleason score, pT3 disease, positive surgical margins, and greater cancer volume (p < 0.0005). The presence of PNI significantly correlated with BCR on univariable (hazard ratio 2.30, 95% confidence interval 1.50-3.55, p < 0.0005), but not multivariable analysis (p = 0.602). On multivariable Cox regression analysis the only independent prognostic factors were preoperative PSA, RP Gleason score, pT-stage, and positive surgical margin status. These findings are limited by a relatively short follow-up time and retrospective study design. CONCLUSIONS: PNI at RP is not an independent predictor of BCR. Therefore, routine reporting of PNI is not indicated. Future research should be targeted at the biology of PNI to increase the understanding of its role in prostate cancer progression.
DOI: 10.5489/cuaj.2619
PubMed URL:
ISSN: 1920-1214
Journal Title: Canadian Urological Association Journal
Type: Journal Article
Affiliated Organisations: Department of Urology and Surgery, University of Melbourne, The Royal Melbourne Hospital, Australia
TissuPath Pty Ltd, Mount Waverley, Australia
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Cancer Services
Epworth Prostate Centre
UroRenal, Vascular

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