Relationship Between Perineural Invasion in Prostate Needle Biopsy Specimens and Pathologic Staging After Radical Prostatectomy

Abstract

BackgroundProstate cancer is the second most common malignancy among men worldwide and the sixth cause of cancer-related death. Some authors have reported a relationship between perineural invasion (PNI), Gleason score, and the invasion of peripheral organs during prostatectomy. However, it is not yet clear whether pathological evidence of PNI is necessary for risk stratification in selecting treatment type.ObjectivesThe clinical and pathological stages of prostate cancer are compared in patients under radical prostatectomy and in patients without perineural invasion.Patients and MethodsThis cross-sectional study was conducted using a sample of 109 patients who attended a tertiary health care center from 2008 to 2013. The selection criteria were PNI in prostate biopsy with Gleason scores less than six, seven, and eight to ten. The participants were enrolled in a census manner, and they underwent clinical staging. After radical prostatectomy, the rates of pathological staging were compared. The under-staging and over-staging rates among those with and without perineural invasion in biopsy samples were compared.ResultsThe concordance between Gleason scores according to biopsy and pathology was 36.7% (40 subjects). The concordance rate was 46.4% and 33.3% among those with and without PNI, respectively. The concordance rates were significantly varied in different subclasses of Gleason scores in patients without PNI (P = 0.003); the highest concordance rate was a Gleason score of 7 (63.6%) and the lowest was a Gleason score of eight to ten (25%). However, there were no significant differences in patients with PNI (P > 0.05).ConclusionsAlthough the presence of PNI in prostate biopsy is accompanied by higher surgical stages, PNI is not an appropriate independent factor in risk stratification.

Perineural invasion, Gleason score and prostate specific antigen; is there any association?

“…finding was stated in the study of Niroomand et al(2).Other studies conducted by Saadat et al and Antunes et al presented similar results as well (9,15). In fact, it seems that, the PNI in prostatic cancer is mostly in association with the duration of malignancy in comparison to age of www.nephropathol.com Journal of Nephropathology, Vol 8, No 4, October 2019 Perineural invasion and PSA 3 patients, though duration of this malignancy may have been longer among older patients.…”

“…In addition, Jeon et al presented that PSA level and Gleason score were significantly higher among patients who had PNI (16). On the other hand, Niroomand et al presented contrary results in their study which was conducted on over 500 patients with prostate cancer (2). This difference may be attributed to different studied samples among the studies.…”

“…Journal of Nephropathology, Vol 8, No 4, October 2019 www.nephropathol.com 2 the invasion has been found to be in relation with PSA levels (2,9,10).…”

“…Prostatic cancer is the second common malignancy in males and is the sixth underlying reason of mortality due to malignancies worldwide (1)(2)(3).…”

Effects of perineural invasion in prostate needle biopsy on tumor grade and biochemical recurrence rates after radical prostatectomy

“…A meta‐analysis concluded that PNB PNI positivity was a significant marker to predict T3 disease and may be included in new nomograms [18]. A recent study found that PNB PNI positivity was correlated with high stage disease; however it was stated that this finding was not significant alone [19]. In spite of this study result, the majority of studies determined a correlation with T3 disease and in our study PNB PNI positivity was correlated with T3 disease, high GS, tumor volume and surgical margin positivity; however it was not significant alone.…”