Prostate biopsy perineural invasion is not independently associated with positive surgical margins following radical retropubic prostatectomy

Abstract

In men undergoing open RP for clinically localized prostate adenocarcinoma, biopsy PNI is associated with an increased risk of BCR. PNI on prostate biopsy was not associated with positive surgical margins after adjusting for related co-variables. The presence of PNI on prostate biopsy should not preclude utilization of a nerve-sparing approach.

Perineural invasion detected in prostate biopsy is a predictor of positive surgical margin of radical prostatectomy specimen: A meta‐analysis

“…After the remaining researches ( n = 59) were screened by full‐text papers, 46 studies were excluded by repeated crowds published, PNI of nonpreoperative biopsy, lack of data or cannot estimate RR, correlation between unexplained PNI and PSM or without enough extractable data. Eventually, 13 observational studies (Al‐Hussain et al, 2011; Cannon et al, 2005; Celik et al, 2018; D'Amico et al, 2001; De La Roca et al, 2014; Delancey et al, 2013; Elharram et al, 2012; Kryvenko et al, 2012; O'Malley et al, 2002; Ramos et al, 2020; Ristau et al, 2015; Truong et al, 2017; Yuksel et al, 2016) involving 8283 patients were included in our study. The flow chart of selection process was showed in Figure 1.…”

“…Tumour cells spread through the perineural space may result from micrometastasis and resection margin residual. As prognostic markers, whether PNI is a predictor of PSM in RP specimen is still debatable (Cannon et al, 2005; D'Amico et al, 2001; Ristau et al, 2015). The aim of our study was to investigate the correlation between PNI of prostate biopsy and PSM after radical prostatectomy.…”

Perineural invasion in prostate biopsy specimens is associated with increased bone metastasis in prostate cancer

“…On the other hand, de la Taille et al demonstrated PNI as an independent preoperative predictor factor of PSA recurrence . A recent study demonstrated that, the patients with PNI on biopsy had 1.5‐fold higher biochemical recurrence after RP . As opposed to these studies, there are conflicting results which show no significance between PNI in the prostate biopsy specimens and clinical or biochemical recurrence .…”

“…Additionally, Stone et al evaluated 212 localized PCa patients, 37 of which had PNI in prostate biopsy specimens: PNI was found to be associated with pelvic lymph node metastasis . In a more recent study, PNI on biopsy had been found to be significantly associated with GS, clinical stage, positive surgical margin, EPE, SVI and lymph node metastasis in univariate analysis, whereas this significance only remained for EPE and SVI in multivariate analysis . Although PNI in RP specimen as opposed to PNI in biopsy has generally been considered to be non‐prognostic in a review article , Ozcan evaluated PNI in 191 RP specimens and found that, it was significantly related with pathologic stage, positive surgical margins, GS and recurrence .…”

Effects of perineural invasion in prostate needle biopsy on tumor grade and biochemical recurrence rates after radical prostatectomy

“…Another study assessed 2500 patients and identified a correlation between PNI positivity on biopsy and advanced stage disease, RRP GS and BR. In PNI positive patients, BR was increased 1.5 times, with no difference reported for surgical margin positivity and total survival [23]. A recent study stated that PNI positivity was an independent predictive factor for BR and that in PNI positive patients BR was correlated to bad prognosis [24].…”