Background: The clinical importance of perineural Invasion (PNI) in prostate cancer (PC) continues to be controversial. This study seeks to evaluate the relationship between the presence of PNI in radical prostatectomy surgical specimens and postoperative biochemical recurrence (BR) in patients with primary treatment for PC. Methods: 116 consecutive patients treated with radical prostatectomy plus pelvic lymphadenectomy for localized or locally advanced prostate cancer were retrospectively reviewed in our institution between July 2010 and December 2019. The relationship between PNI and clinicopathological characteristics was analyzed using multivariate analysis, as well as the biochemical recurrence in the face of this event. Survival analyzes to biochemical failure were performed for individuals with and without PNI and for patients according to risk groups, applying the Kaplan-Meier method. Ultimately, predictors of biochemical recurrence were estimated. Results: The mean follow-up was 42.64 months. 75% of the patients presented PNI and 36.21% presented biochemical recurrence. The latter was associated with the presence of PNI (p<0.001). Patients with PNI presented higher proportions of unfavorable histological indicators in relation to several of the pre-surgical variables, as international society of urological pathology (ISUP) grade, PC risk group, and number of positive cores, compared to patients who did not present PNI. A similar situation was observed in post-surgical variables, with significant differences between the groups with and without PNI for pathological ISUP grade, seminal vesicle invasion, positive surgical margins, post-surgical clinical stage and post-surgical PSA. Furthermore, the biochemical relapse-free survival of the patients with PNI was lower compared to the group without PNI (p<0.01). Multiple variables were found as predictors of biochemical recurrence after surgery, however, in the multivariate analysis, PNI was a predictor for BR (HR: 4.07; NC95%: 1.038-15.953). Finally, in the multivariate adjustment, patients in intermediate and high-risk groups showed more chances of presenting PNI than low-risk patients (OR: 5.25; 95% CI: 1.767-15.606). Conclusions: The presence of PNI in patients treated with radical prostatectomy for PC is associated with a lower biochemical recurrence-free survival, with unfavorable histological characteristics, and is an independent prognostic factor for postoperative biochemical recurrence.
CLO22-039 Figure. Survival curve to biochemical recurrence of a cohort of prostate cancer patients treated with radical prostatectomy according to the presence of perineural invasion (PNI).
Citation: Journal of the National Comprehensive Cancer Network 20, 3.5; 10.6004/jnccn.2021.7128
CLO22-039 Figure. Survival curve to biochemical recurrence of a cohort of prostate cancer patients treated with radical prostatectomy according to the presence of perineural invasion (PNI).
Citation: Journal of the National Comprehensive Cancer Network 20, 3.5; 10.6004/jnccn.2021.7128
CLO22-039 Figure. Survival curve to biochemical recurrence of a cohort of prostate cancer patients treated with radical prostatectomy according to the presence of perineural invasion (PNI).
Citation: Journal of the National Comprehensive Cancer Network 20, 3.5; 10.6004/jnccn.2021.7128
