Perineural invasion by transitional cell carcinoma of the bladder in patients submitted to radical cystectomy: what is the prognostic value?

Abstract

Objective: Determine the prognostic value of perineural invasion (PNI) in patients with transitional cell carcinoma (TCC) of the bladder treated with radical cystectomy. Materials and Methods: From January 1993 to January 2005, 113 people were selected from 153 patients with TCC of the bladder treated with radical cystectomy. The association between the presence of PNI and other pathologic characteristics were analyzed through Fisher exact test. The Kaplan-Meier method was utilized to assess the survival curve and the statistical significance was determined by the Breslow test. The multivariate analysis was performed through the Cox regression model. Results: The PNI was identified in 10 (8.8%) of the 113 patients. This variable significantly related to the microvascular invasion and to tumor staging. The mean segment after surgery was 31.7 ± 28.5 months. Recurrence occurred in 5 (50%) and in 41 (39.8%) patients (p = 0.363) and mortality occurred in 2 (20%) and 22 (21.9%) patients (p = 0.606) with or without PNI respectively. In Cox regression analysis, patients with PNI presented with 1.53 times (IC 95% 0.60 to 3.91; p = 0.371) and 1.60 times (IC 95% 0.37 to 6.95; p = 0.532) the risk of recurrence and mortality when compared to patients without PNI. Conclusions: The PNI does not constitute an independent variable of disease-free and cancer specific survival in patients with TCC of the bladder treated with radical cystectomy.

Adductor Muscle Atrophy Due to Obturator Nerve Compression by Metastatic Lymph Node Enlargement?A Rare Complication of Recurrent Bladder Cancer

“…The latter is a more plausible explanation, considering the infrequent pattern of perineural invasion of transitional cell carcinoma [11]. In support of this, the MRI images from this patient demonstrate a plane of cleavage between the involved lymph node and obturator nerve ( Figure 5).…”

An Investigation of the Pathology Report of Bladder Cancer Patients with Radical Cystectomy in Southern Iran, 2013-2018: A Cross-Sectional Study

“…It was suggested that PNI with UCC might be accompanied by inferior prognosis, specifically for extravesical and LN-positive disease subsequent RC ( 15 ). On the other hand, Antunes et al identified PNI in 10 (8.8%) out of 113 patients and concluded that PNI did not constitute an independent factor of cancer-free and survival rate ( 16 ). This different finding across all articles might be due to variable cohort sizes and varied study populations.…”

Carcinomas uroteliais de bexiga: aspectos anatomopatológicos e imuno-histoquímicos. Pesquisa de metaloproteinases de matriz utilizando a técnica de tissue microarray (TMA)

“…Uma observação curiosa foi a frequência relativamente elevada da detecção de invasão perineural na nossa casuística (38 casos -62,3%), achado maior que em estudos prévios relatados, nos quais variam entre 6,8% e 47,7% (98). Mesmo com 38 casos exibindo a invasão perineural, nenhuma associação significativa foi observada com a expressão das MMPs, talvez devido à baixa importância desse achado morfológico no que diz respeito aos fatores de impacto do carcinoma urotelial, ou porque os endpoints mais adequados para tal avaliação sejam os critérios clínicos que referimos anteriormente quanto à invasão vascular.…”