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Perineural invasion on prostate biopsy does not predict adverse pathological outcome
Malik Elharram1, David Margel, Antonio Finelli
1University of Toronto, Toronto, Ontario, Canada.
The Canadian Journal of Urology
|December 12, 2012
Summary
Perineural invasion on prostate needle biopsy does not predict adverse findings at radical prostatectomy. This finding suggests prostate needle biopsy perineural invasion has limited value in predicting prostate cancer outcomes.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- The clinical significance of perineural invasion (PNI) on prostate needle biopsy is debated.
- PNI is defined as carcinoma tracking along or around a nerve in the perineural space.
Purpose of the Study:
- To determine if PNI on prostate biopsy predicts adverse findings at radical prostatectomy.
- To assess the predictive value of biopsy PNI for PNI at radical prostatectomy.
Main Methods:
- Analysis of 470 prostate cancer patients from a prospectively maintained database.
- 139 patients underwent radical prostatectomy; pathological specimens were examined for PNI.
- Investigated the predictive value of biopsy PNI for radical prostatectomy outcomes and PNI presence.
Main Results:
- PNI was present in 26% of biopsy specimens and 68% of radical prostatectomy specimens.
- Biopsy PNI did not predict radical prostatectomy Gleason score, pathological stage, or margin status.
- The sensitivity and specificity of biopsy PNI for predicting PNI at radical prostatectomy were 32% and 82%, respectively.
Conclusions:
- PNI on prostate needle biopsy is not predictive of radical prostatectomy outcomes.
- Biopsy PNI has limited predictive value for PNI at radical prostatectomy.
