Perineural invasion as an independent predictor of biochemical recurrence in prostate cancer following radical prostatectomy or radiotherapy: a systematic review and meta-analysis

Zhang, Lijin; Wu, Bin; Zha, Zhenlei; Qu, Wei; Hu, Zhao; Yuan, Jun; Feng, Yuyao

doi:10.1186/s12894-018-0319-6

Cited by 49 publications

(41 citation statements)

References 45 publications

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“…24 The importance of a perineurial invasion detected in a prostate biopsy specimen is controversial. 25 In the present study, we did not find a relation between perineural invasion and PSM.…”

Section: Discussioncontrasting

confidence: 72%

Assessment of Preoperative Predictive Factors for Positive Surgical Margins in Patients with Low or Intermediate Risk Prostate Cancer Who Underwent Retropubic Radical Prostatectomy

Çoşkun¹,

Ergenekon²

2019

J Reconstr Urol

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Positive surgical margins after radical prostatectomy is important due to increased risk of biochemical recurrence. Preoperative clinical stage, prostate specific antigen (PSA) value and the Gleason Score are the predictors of surgical margin status. In this study we aimed to assess the effects of preoperative variables on surgical margin positivity in patients with low or intermediate risk. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Preoperative clinical stage, PSA value, prostate volume and variables obtained from prostate biopsies of 73 patients who were grouped in low or intermediate risk according to D'Amico criteria (Clinical satge≤ T2b, PSA<10 ng/dl, Gleason Score ≤ 7) were compared with regard to surgical margin positivity status retrospectively. R Re es su ul lt ts s: : The rate of the patients with positive surgical margins was 23.3%. The mean prostate volume was 84.91 ml±21.43 and 56.05 ml±18.42 in negative and positive surgical margin groups, respectively (p=0.001). While 14.6% of the patients with a PSA level <10 ng/dl had positive surgical margins, this rate was 34.4% in the patients with a PSA level of 10-20 ng/dl. (p=0.05). Increased numbers of positive cores in prostate biopsy were related with positive surgical margins (p=0.001). In multivariate analysis, only, prostate volumes less than 70 ml was found to be statistically significant (p=0.023). C Co on nc cl lu us si io on n: : Smaller prostate volumes less than 70 ml. increase the risk of positive surgical margins in patients with low or intermediate risk. K Ke ey yw wo or rd ds s: : Margins of excision; prostatic cancer Ö ÖZ ZE ET T A Am ma aç ç: : Radikal prostatektomi sonrası cerrahi sınırların pozitif olması biyokimyasal rekürrens riskini artırması nedeniyle önemlidir. Operasyon öncesi klinik evre, PSA değeri ve Gleason Skoru pozitif cerrahi sınırlar açısından belirleyici özelliktedir. Bu çalışmada, düşük ve orta risk özellikleriyle radikal prostatektomi uygulanan hastalarda operasyon öncesi verilerin cerrahi sınır pozitifliği üzerine olan etkisini araştırmayı amaçladık. G Ge er re eç ç v ve e Y Yö ön n-t te em ml le er r: : Retrospektif olarak D'Amico kriterlerine göre düşük ve orta risk grubunda (klinik evre ≤ T2b, PSA<10 ng/dl, Gleason Skoru ≤ 7) olan 73 hastanın ameliyat öncesi klinik evre, PSA değeri, prostat hacmi ve prostat biyopsisinden elde edilen verileri pozitif cerrahi sınır saptanmasına göre karşılaştırıldı. B Bu ul lg gu ul la ar r: : Pozitif cerrahi sınır saptanan hastaların oranı %23,3 idi. Ortalama prostat hacmi negatif cerrahi sınır grubunda 84,91 ml±21,43 ve pozitif cerrahi sınır grubunda 56,05 ml±18,42 olarak bulundu (p=0,001). PSA seviyesi 10 ng/dl'den düşük olan hastalarda cerrahi sınır pozitifliği oranı %14,6 bulunurken, PSA seviyesi 10-20 ng/dl arasında olan hastalarda bu oran %34,4 olarak bulundu (p=0,05). Prostat biyopsisinde artmış pozitif kor sayıları pozitif cerrahi sınır ile ilişkili bulundu (p=0,001). Çoklu değişken analizinde ise sadece prostat hacminin 70 ml'den az olması istatistiksel olar...

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Section: Discussioncontrasting

confidence: 72%

Assessment of Preoperative Predictive Factors for Positive Surgical Margins in Patients with Low or Intermediate Risk Prostate Cancer Who Underwent Retropubic Radical Prostatectomy

Çoşkun¹,

Ergenekon²

2019

J Reconstr Urol

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“…It has been reported that PNI was significantly associated with recurrence and poor survival outcome in pancreatic cancer, prostate cancer and colorectal cancer 11–14. Furthermore, there have been several studies evaluating the prognostic significance of PNI for GC patients, but the results were conflicting.…”

Section: Introductionmentioning

confidence: 99%

Perineural invasion as a predictive factor for survival outcome in gastric cancer patients: a systematic review and meta-analysis

Zhao

Mei

et al. 2020

J Clin Pathol

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AimsThe prognostic significance of perineural invasion (PNI) for gastric cancer (GC) patients was under debate. This study aimed to review relevant studies and evaluate the impact of PNI on the survival outcome of GC patients.MethodsSystematic literature search was performed using PubMed and Embase databases. The relevant data were extracted, and the association between PNI and clinicopathological characteristics or survival outcome in GC patients were evaluated using a fixed-effect model or random-effect model.ResultsA total 13 studies involving 7004 GC patients were included in this meta-analysis. The positive rate of PNI was 35.9% (2512/7004) in GC patients, ranging from 6.9% to 75.6%. There were significant relationships between PNI and a series of unfavourable clinicopathological factors including undifferentiated histology type (OR: 1.78, 95% CI 1.37 to 2.33, p<0.001; I2=75.3%), diffuse type (OR: 1.96, 95% CI 1.07 to 3.60, p=0.029; I2=79.5%), lymphatic invasion (OR: 7.00, 95% CI 3.76 to 13.03, p<0.001; I2=83.6%), vascular invasion (OR: 5.79, 95% CI 1.59 to 21.13, p=0.008; I2=95.8%), deeper tumour invasion (OR: 4.79, 95% CI 3.65 to 6.28, p<0.001; I2=65.0%) and lymph node metastasis (OR: 3.60, 95% CI 2.37 to 5.47, p<0.001; I2=89.6%). In addition, PNI was significantly associated with worse survival outcome in GC patients (HR: 1.69, 95% CI 1.38 to 2.06, p<0.001; I2=71.0%).ConclusionPNI was frequently detected in surgically resected specimens of GC patients, and it was a predictive factor for survival outcomes in these patients.

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“…Yet, its incidence varies among different studies, with a proportion ranging from 23% to 90% in the radical prostatectomy (RP) specimen and 7% to 43% in the biopsy specimen (Harnden et al ., ; Merrilees et al ., ; Masieri et al ., ; Tollefson et al ., ). Although the exact clinical value of PNI remains controversial (Zareba et al ., ; Zhang et al ., ), the presence of PNI is still considered as one of the important mechanisms of PCa cells spreading beyond the prostate (Villers et al ., ). Remarkably, apart from the classic routes of metastatic spread of tumor cells, for example, lymphatic and hematogenous, peripheral nerve is also recognized as a crucial route of PCa spreading.…”

Section: Introductionmentioning

confidence: 99%

The clinical significance of perineural invasion in patients with de novo metastatic prostate cancer

et al. 2019

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Background:The clinical value of perineural invasion (PNI) in patients with localized prostate cancer (PCa) is widely explored. However, its role in metastatic PCa (mPCa) remains unknown. Objectives: We aim to investigate the clinical significance of PNI in patients with mPCa. Materials and methods: Data of 515 mPCa patients between 2012 and 2018 were retrospectively studied. PNI and its intensity were identified by prostate biopsy. The prognostic value of PNI was evaluated by Kaplan-Meier curves and Cox proportional-hazards model. Results: Perineural invasion was detected in 170/515 (33.0%) cases. Among them 73/170 (42.9%) and 97/170 (57.1%) harbored unifocal PNI (uni-PNI) and multifocal PNI (multi-PNI), respectively. Compared to patients without PNI, those with PNI had statistically shorter castration-resistant PCa-free survival (CFS) and numerically shorter overall survival (OS) (mCFS: 15.4-vs. 18.5-Mo, p = 0.015; mOS: 63.8-vs. 71.4-Mo, p = 0.108). Patients harboring multi-PNI were associated with poorer clinical outcomes than those with uni-PNI (mCFS: 12.4-vs. 18.0-Mo, p = 0.040; mOS: 39.7-Mo vs. NR, p = 0.018) or those without PNI (mCFS: 12.4-vs. 18.5-Mo, p = 0.002; mOS: 39.7-vs. 71.4-Mo, p = 0.002). Totally, neither uni-PNI nor multi-PNI was an independent risk factor impacting survival outcomes in multivariate analyses. While remarkably, for patients with favorable/intermediate-risk mPCa, multi-PNI was an independent adverse prognosticator for both CFS and OS (CFS: HR: 1.705, 95% CI: 1.029-2.825, p = 0.038; OS: HR: 3.294, 95% CI: 1.464-7.413, p = 0.004). Discussion and Conclusion: This study filled the blank of the clinical significance of PNI in mPCa. We found that multi-PNI could distinguish men with relatively poor prognosis from patients initially regarded as with favorable survival outcomes by other prognosticators, and thus, avoid disease underestimation in this group of patients. Our finding would help physicians have a deeper understanding of the heterogeneity of mPCa and make better individualized therapeutic strategy.

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Perineural invasion as an independent predictor of biochemical recurrence in prostate cancer following radical prostatectomy or radiotherapy: a systematic review and meta-analysis

Cited by 49 publications

References 45 publications

Assessment of Preoperative Predictive Factors for Positive Surgical Margins in Patients with Low or Intermediate Risk Prostate Cancer Who Underwent Retropubic Radical Prostatectomy

Assessment of Preoperative Predictive Factors for Positive Surgical Margins in Patients with Low or Intermediate Risk Prostate Cancer Who Underwent Retropubic Radical Prostatectomy

Perineural invasion as a predictive factor for survival outcome in gastric cancer patients: a systematic review and meta-analysis

The clinical significance of perineural invasion in patients with de novo metastatic prostate cancer

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