Quantification of perineural invasion focus after radical prostatectomy could improve predictive power of recurrence

Wu, Shulin; Xie, Ling; Lin, Sharron X.; Wirth, Grégory J.; Lu, Min; Zhang, Yifen; Blute, Michael L.; Dahl, Douglas M.; Wu, Chin‐Lee

doi:10.1016/j.humpath.2020.07.005

Cited by 14 publications

(18 citation statements)

References 47 publications

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“…11 A more recent study with 721 cases demonstrated the prognostic value of more than 3 PNIs, as an independent factor, compared with no PNI (HR, 2.12; P ¼ .044), but the difference between 1 to 3 and more than 3 PNIs was not assessed. 12 In addition, 10 or more PNIs detected only in the extraprostatic tissue were found to associate with a significantly higher risk of biochemical recurrence even in a multivariate setting. 24 Our present data on the quantification of biopsy PNI sites are thus compatible with previous PNI findings in radical prostatectomy specimens and may be more useful for decision making for the management of prostate cancer.…”

Section: Resultsmentioning

confidence: 90%

“…Specifically, several studies have suggested that PNI in prostatectomy specimens holds no value as an independent prognosticator. 12,21 By contrast, the clinical impact of PNI quantification in prostate biopsy specimens has not been fully investigated. Therefore, in the present study, we compared clinicopathologic findings, including those on radical prostatectomy, as well as longterm outcomes, in men whose biopsy specimen had exhibited PNI in 1 to 6 sextant sites of the specimen.…”

Section: Resultsmentioning

confidence: 99%

“…23 PNI quantification has been studied in radical prostatectomy specimens, demonstrating its role as a prognosticator. [10][11][12]24 For instance, a study involving 265 prostatectomies showed that the incidence of biochemical recurrence was significantly higher in cases with multifocal PNIs (n ¼ 32) than in those with unifocal PNI (n ¼ 91) (HR, 4.81; P , .001) 10 In another study using 114 prostatectomy specimens where S-100 protein was immunohistochemically stained for assisting the detection of nerves, overall survival times in patients with less than 1 PNI and 1 or more PNI(s) per 5 high-power fields were 159 and 173 months, respectively (P ¼ .047). 11 A more recent study with 721 cases demonstrated the prognostic value of more than 3 PNIs, as an independent factor, compared with no PNI (HR, 2.12; P ¼ .044), but the difference between 1 to 3 and more than 3 PNIs was not assessed.…”

Section: Resultsmentioning

confidence: 99%

“…[6][7][8][9] The quantity of PNI in radical prostatectomy specimens has also been explored. [10][11][12] However, little is known about the role of PNI quantification in prostate biopsy specimens.…”

mentioning

confidence: 99%

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The Clinical Significance of Perineural Invasion by Prostate Cancer on Needle Core Biopsy: Involvement of Single Versus Multiple Sextant Sites

Bell

Teramoto

Gurung

et al. 2022

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Perineural invasion (PNI) by prostate cancer has been associated with adverse pathology, including extraprostatic extension. However, the significance of PNI quantification on prostate biopsy (PBx) remains unclear. Objective.— To compare radical prostatectomy (RP) findings and long-term outcomes in patients whose PBx had exhibited PNI. Design.— We assessed 497 consecutive patients undergoing sextant (6-site/≥12-core) PBx showing conventional adenocarcinoma followed by RP. Results.— PNI was found in 1 (n = 290)/2 (n = 132)/3 (n = 47)/4 (n = 19)/5 (n = 5)/6 (n = 4) of the sites/regions of PBx. Compared with a single PNI site, multiple PNIs were significantly associated with higher preoperative prostate-specific antigen, higher Grade Group (GG) on PBx or RP, higher pT or pN category, positive surgical margin, and larger estimated tumor volume. When compared in subgroups of patients based on PBx GG, significant differences in RP GG (GG1–3), pT (GG1–2/GG1–3/GG2/GG3), surgical margin status (GG1–3/GG3/GG5), or tumor volume (GG1–2/GG1–3/GG2/GG3) between 1 versus multiple PNIs were observed. Moreover, there were significant differences in prostate-specific antigen (PNI sites: 1–2 versus 3–6/1–3 versus 4–6/1–4 versus 5–6), RP GG (1–3 versus 4–6/1–4 versus 5–6), pT (1–2 versus 3–6/1–3 versus 4–6), pN (1–3 versus 4–6), or tumor volume (1–2 versus 3–6/1–4 versus 5–6). Outcome analysis revealed significantly higher risks of disease progression in the entire cohort or PBx GG1–2/GG1–3/GG2/GG3/GG5 cases showing 2 to 6 PNIs, compared with respective controls with 1-site PNI. In multivariate analysis, multisite PNI was an independent predictor for progression (hazard ratio = 1.556, P = .03). Conclusions.— Multiple sites of PNI on PBx were associated with worse histopathologic features in RP specimens and poorer prognosis. PNI may thus need to be specified, if present, in every sextant site on PBx, especially those showing GG1–3 cancer.

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Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

The Clinical Significance of Perineural Invasion by Prostate Cancer on Needle Core Biopsy: Involvement of Single Versus Multiple Sextant Sites

Bell

Teramoto

Gurung

et al. 2022

Archives of Pathology &Amp; Laboratory Medicine

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“…Previous studies have identified several clinicopathological factors including Gleason score, TNM stage, and margin status as predictive variables for BCR [ 5 , 6 ]. However, for the great heterogeneity of PCa, prognosis varies significantly in PCa patients with same tumor stage and similar clinicopathological features [ 7 , 8 ]. Therefore, more ideal biomarker and predictive model are warranted to be developed.…”

Section: Introductionmentioning

confidence: 99%

Construction and Validation of a Robust Cancer Stem Cell-Associated Gene Set-Based Signature to Predict Early Biochemical Recurrence in Prostate Cancer

Liu

et al. 2020

Disease Markers

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Background. Postoperative early biochemical recurrence (BCR) was an essential indicator for recurrence and distant metastasis of prostate cancer (PCa). The aim of this study was to construct a cancer stem cell- (CSC-) associated gene set-based signature to identify a subgroup of PCa patients who are at high risk of early BCR. Methods. The PCa dataset from The Cancer Genome Atlas (TCGA) was randomly separated into discovery and validation set. Patients in discovery set were divided into early BCR group and long-term survival group. Propensity score matching analysis and differentially expressed gene selection were used to identify candidate CSC-associated genes. The LASSO Cox regression model was finally performed to filter the most useful prognostic CSC-associated genes for predicting early BCR. Results. By applying the LASSO Cox regression model, we built a thirteen-CSC-associated gene-based early BCR-predicting signature. In the discovery set, patients in high-risk group showed significantly poorer BCR free survival than that patients in low-risk group (HR: 4.91, 95% CI: 2.75–8.76, P < 0.001 ). The results were further validated in the internal validation set (HR: 2.99, 95% CI: 1.34–6.70, P = 0.005 ). Time-dependent ROC at 1 year suggested that the CSC gene signature ( AUC = 0.800 ) possessed better predictive value than any other clinicopathological features in the entire TCGA cohort. Additionally, survival decision curve analysis revealed a considerable clinical usefulness of the CSC gene signature. Conclusions. We successfully developed a CSC-associated gene set-based signature that can accurately predict early BCR in PCa cancer.

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Quantification of perineural invasion in pancreatic ductal adenocarcinoma: proposal of a severity score system

et al. 2023

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Quantification of perineural invasion focus after radical prostatectomy could improve predictive power of recurrence

Cited by 14 publications

References 47 publications

The Clinical Significance of Perineural Invasion by Prostate Cancer on Needle Core Biopsy: Involvement of Single Versus Multiple Sextant Sites

The Clinical Significance of Perineural Invasion by Prostate Cancer on Needle Core Biopsy: Involvement of Single Versus Multiple Sextant Sites

Construction and Validation of a Robust Cancer Stem Cell-Associated Gene Set-Based Signature to Predict Early Biochemical Recurrence in Prostate Cancer

Quantification of perineural invasion in pancreatic ductal adenocarcinoma: proposal of a severity score system

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