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Impact of uni- or multifocal perineural invasion in prostate cancer at radical prostatectomy
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 de...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7844528/ https://www.ncbi.nlm.nih.gov/pubmed/33532297 http://dx.doi.org/10.21037/tau-20-850 |
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author | Sciarra, Alessandro Maggi, Martina Del Proposto, Arianna Magliocca, Fabio Massimo Ciardi, Antonio Panebianco, Valeria De Berardinis, Ettore Salciccia, Stefano Di Pierro, Giovanni Battista Gentilucci, Alessandro Kasman, Alex M. Chung, Benjamin I. Ferro, Matteo de Cobelli, Ottavio Del Giudice, Francesco Busetto, Gian Maria Gallucci, Michele Frisenda, Marco |
author_facet | Sciarra, Alessandro Maggi, Martina Del Proposto, Arianna Magliocca, Fabio Massimo Ciardi, Antonio Panebianco, Valeria De Berardinis, Ettore Salciccia, Stefano Di Pierro, Giovanni Battista Gentilucci, Alessandro Kasman, Alex M. Chung, Benjamin I. Ferro, Matteo de Cobelli, Ottavio Del Giudice, Francesco Busetto, Gian Maria Gallucci, Michele Frisenda, Marco |
author_sort | Sciarra, Alessandro |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7844528 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-78445282021-02-01 Impact of uni- or multifocal perineural invasion in prostate cancer at radical prostatectomy Sciarra, Alessandro Maggi, Martina Del Proposto, Arianna Magliocca, Fabio Massimo Ciardi, Antonio Panebianco, Valeria De Berardinis, Ettore Salciccia, Stefano Di Pierro, Giovanni Battista Gentilucci, Alessandro Kasman, Alex M. Chung, Benjamin I. Ferro, Matteo de Cobelli, Ottavio Del Giudice, Francesco Busetto, Gian Maria Gallucci, Michele Frisenda, Marco Transl Androl Urol Original Article 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. AME Publishing Company 2021-01 /pmc/articles/PMC7844528/ /pubmed/33532297 http://dx.doi.org/10.21037/tau-20-850 Text en 2021 Translational Andrology and Urology. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Sciarra, Alessandro Maggi, Martina Del Proposto, Arianna Magliocca, Fabio Massimo Ciardi, Antonio Panebianco, Valeria De Berardinis, Ettore Salciccia, Stefano Di Pierro, Giovanni Battista Gentilucci, Alessandro Kasman, Alex M. Chung, Benjamin I. Ferro, Matteo de Cobelli, Ottavio Del Giudice, Francesco Busetto, Gian Maria Gallucci, Michele Frisenda, Marco Impact of uni- or multifocal perineural invasion in prostate cancer at radical prostatectomy |
title | Impact of uni- or multifocal perineural invasion in prostate cancer at radical prostatectomy |
title_full | Impact of uni- or multifocal perineural invasion in prostate cancer at radical prostatectomy |
title_fullStr | Impact of uni- or multifocal perineural invasion in prostate cancer at radical prostatectomy |
title_full_unstemmed | Impact of uni- or multifocal perineural invasion in prostate cancer at radical prostatectomy |
title_short | Impact of uni- or multifocal perineural invasion in prostate cancer at radical prostatectomy |
title_sort | impact of uni- or multifocal perineural invasion in prostate cancer at radical prostatectomy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7844528/ https://www.ncbi.nlm.nih.gov/pubmed/33532297 http://dx.doi.org/10.21037/tau-20-850 |
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