Perineural invasion is an independent predictor of biochemical recurrence of prostate cancer after local treatment: a meta-analysis.

Controversy still existed regarding the role of perineural invasion (PNI) in prostate cancer. The present meta-analysis aimed to investigate the association between PNI and biochemical recurrence (BCR) of prostate cancer after local treatment. A systematic search of Medline, Embase and CENTRAL was performed for eligible studies. Pooled estimates of hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were acquired by using the generic inverse variance method. Subgroup analyses were performed by the method treating prostate cancer including radical prostatectomy (RP) and radiotherapy (RT) as well as the specimens which were acquired from RP and biopsy. A total of 12 studies incorporating 5188 patients were included in the meta-analysis. Overall, PNI was significantly associated with BCR (HR 1.59, 95% CI 1.37-1.84). Similarly, a significant correlation between PNI and BCR was also found in RP series (HR 1.51, 95% CI 1.25-1.83) and RT series (HR 1.70, 95% CI 1.35-2.13). PNI predicted BCR of prostate cancer in both RP (HR 1.51, 95% CI 1.23-1.85) and biopsy specimens (HR 1.68, 95% CI 1.36-2.09). PNI was demonstrated to be associated with higher risk for BCR of prostate cancer after local treatment. Therefore, PNI should be considered when assessing the risk of BCR in prostate cancer, thereby to achieve the best treatment.