Impact of uni- or multifocal perineural invasion in prostate cancer at radical prostatectomy
Articolo
Data di Pubblicazione:
2021
Citazione:
Impact of uni- or multifocal perineural invasion in prostate cancer at radical prostatectomy / A. Sciarra, M. Maggi, A.D. Proposto, F.M. Magliocca, A. Ciardi, V. Panebianco, E. de Berardinis, S. Salciccia, G.B. Di Pierro, A. Gentilucci, A.M. Kasman, B.I. Chung, M. Ferro, O. de Cobelli, F.D. Giudice, G.M. Busetto, M. Gallucci, M. Frisenda. - In: TRANSLATIONAL ANDROLOGY AND UROLOGY. - ISSN 2223-4683. - 10:1(2021 Jan), pp. 66-76. [10.21037/TAU-20-850]
Abstract:
Background: Aim of this study was to correlate perineural invasion (PNI) with other clinical-pathological parameters in terms of prognostic indicators in prostate cancer (PC) cases at the time of radical prostatectomy (RP). Methods: Prospective study of 288 consecutive PC cases undergoing RP. PNI determination was performed either in biopsy or in RP specimens classifying as uni- and multifocal PNI. The median follow-up time was 22 (range, 6–36) months. Results: At biopsy PNI was found in 34 (11.8%) cases and in 202 (70.1%) cases at the time of surgery. Among those identified at RP 133 (46.1%) and 69 (23.9%) cases had uni- and multi-PNI, respectively. Presence of PNI was significantly (P<0.05) correlated with unfavorable pathological parameters such higher stage and grade. The percentage of extracapsular extension in PNI negative RP specimens was 18.6% vs. 60.4% of PNI positive specimens. However, the distribution of pathological staging and International Society of Urological Pathology (ISUP) grading did not vary according to whether PNI was uni- or multifocal. The risk of biochemical progression increased 2.3 times in PNI positive cases was significantly associated with the risk of biochemical progression (r=0.136; P=0.04). However, at multivariate analysis PNI was not significantly associated with biochemical progression [hazard ratio (HR): 1.87, 95% confidence interval (CI): 0.68–3.12; P=0.089]. Within patients with intermediate risk disease, multifocal PNI was able to predict cases with lower mean time to biochemical and progression free survival (chi-square 5.95; P=0.04). Conclusions: PNI at biopsy is not a good predictor of the PNI incidence at the time of RP. PNI detection in surgical specimens may help stratify intermediate risk cases for the risk of biochemical progression.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Perineural invasion (PNI); Prostatic neoplasm; Radical prostatectomy (RP)
Elenco autori:
A. Sciarra, M. Maggi, A.D. Proposto, F.M. Magliocca, A. Ciardi, V. Panebianco, E. de Berardinis, S. Salciccia, G.B. Di Pierro, A. Gentilucci, A.M. Kasman, B.I. Chung, M. Ferro, O. de Cobelli, F.D. Giudice, G.M. Busetto, M. Gallucci, M. Frisenda
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