The relationship between early biochemical failure and perineural invasion in pathological T2 prostate cancer

Endrizzi, Joseph; Seay, Thomas M.

doi:10.1046/j.1464-410x.2000.00518.x

Cited by 42 publications

(29 citation statements)

References 11 publications

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“…16 The presence of perineural invasion has also been shown to have a greater positive-predictive value for PSA recurrence than either Gleason score Z7 and preoperative serum PSA 410 ng/ml. 22 These findings, however, are contradicted by the rather surprising observation that the presence of perineural invasion was associated with increased biochemical recurrence-free survival interval. 19 While perineural invasion is recognized as a common feature of prostate adenocarcinoma in glands removed by radical prostatectomy, the proportion of involved nerves varies from series to series.…”

Section: Discussionmentioning

confidence: 97%

“…19 While perineural invasion is recognized as a common feature of prostate adenocarcinoma in glands removed by radical prostatectomy, the proportion of involved nerves varies from series to series. In studies based upon a review of pathology reports, without re-examination of histology, perineural invasion was noted in 31.9-60.5% of specimens, 16,22,23 while in series in which review of sections was undertaken, the incidence ranged from 74 to 84%, with the majority series being in the order of 75%. [13][14][15][17][18][19] Our finding that 90% of specimens showed perineural invasion, following identification of nerves using S-100 protein immunostaining, demonstrates that even after review, some nerves showing perineural invasion are overlooked.…”

Section: Discussionmentioning

confidence: 99%

“…It is of interest that the two series that showed perineural invasion to have a significant association with biochemical recurrence on multivariate analysis were based on examination of histology reporting without formal review of the sections by a pathologist. 16,22 This, along with small sample size of some series, may have acted as a confounding influence in previous studies that have investigated the prognostic significance of perineural invasion in radical prostatectomy specimens.…”

Section: Discussionmentioning

confidence: 99%

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Parameters of perineural invasion in radical prostatectomy specimens lack prognostic significance

et al. 2008

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The prognostic significance of perineural invasion by prostate cancer is debated. We have evaluated the association between biochemical failure and measurements of perineural invasion in radical prostatectomy specimens. Perineural invasion was identified in sections using S-100 protein immunostaining. For nerves showing invasion, the involved nerve closest to the edge of the prostate and to the surgical excision margin, as well as the diameter of these nerves, the largest nerve showing perineural invasion and its proximity to the excision margin, and the percentage of nerves showing perineural invasion up to 1.75 mm from the excision margin was determined and tested against time to prostate-specific antigen failure, along with preoperative prostate-specific antigen levels, highest Gleason primary grade, Gleason score and TNM T category. Perineural invasion was present in 90% of cases, with extraprostatic perineural invasion in 25% of tumors. Diameter of nerves showing perineural invasion ranged from 11 to 680 lm and the shortest distance to the surgical excision margin ranged from 33 to 2.57 mm. Perineural invasion density ranged from 6 to 96%. Gleason scores were six in 58 cases, seven in 43 cases, eight in three cases and nine in one case. Clinical T categories were T1c in 75 cases, T2a in 22 cases, T2b in five cases, T2c in two cases, T3 in one case. During a follow-up period of 11 to 55 months (median 26 months), 27 patients showed prostate-specific antigen failure. On univariate analysis only presence of extraprostatic perineural invasion, among parameters of perineural invasion, showed a weak correlation with outcome, while on multivariate analysis this lost significance and preoperative prostatespecific antigen levels, Gleason score and excision margin status were independently associated with biochemical failure. We conclude that the investigated parameters of perineural invasion do not predict prostate-specific antigen recurrence in radical prostatectomy specimens.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Parameters of perineural invasion in radical prostatectomy specimens lack prognostic significance

et al. 2008

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“…Although a number of studies have found that PNI predicts BCR on univariable analysis, [7][8][9][10][11][12][13][14][15] only two studies have reported PNI as a significant predictor on multivariable analysis. 8,13 Both of these studies examined relatively small cohorts of fewer than 250 participants.…”

Section: Discussionmentioning

confidence: 99%

Does perineural invasion in a radical prostatectomy specimen predict biochemical recurrence in men with prostate cancer?

Reeves

Hovens

Harewood

et al. 2015

CUAJ

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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.

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“…In many studies that report on it, it is an observational finding. For example, in one study (89), of the 17 patients that recurred, 1 4 ( 8 2 % ) h a d p e r i n e u r a l i n v a s i o n . O t h e r t h a n t h a t observation, no real correlation of PNI with failure was possible.…”

Section: Modifying Factorsmentioning

confidence: 99%

Prognostic Factors for Failure after Prostatectomy

Swanson¹,

Basler²

2011

J. Cancer

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The relationship between early biochemical failure and perineural invasion in pathological T2 prostate cancer

Cited by 42 publications

References 11 publications

Parameters of perineural invasion in radical prostatectomy specimens lack prognostic significance

Parameters of perineural invasion in radical prostatectomy specimens lack prognostic significance

Does perineural invasion in a radical prostatectomy specimen predict biochemical recurrence in men with prostate cancer?

Prognostic Factors for Failure after Prostatectomy

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