Mladen Stankovic1, Laura Wolff2, Teresa Wieder2, Joao Mendes2, Bastian Schumacher2. 1. Department of Urology, Salem Hospital, Academic Hospital, University of Heidelberg, Zeppelinstraße 11-33, 69121, Heidelberg, Germany. mladen.stankovic@stadtmission-hd.de. 2. Department of Urology, Salem Hospital, Academic Hospital, University of Heidelberg, Zeppelinstraße 11-33, 69121, Heidelberg, Germany.
Abstract
PURPOSE: To explore the association between perineural invasion (PNI) and biochemical recurrence (BCR) in patients undergoing open radical prostatectomy (ORP). METHODS: A retrospective observational study was conducted, in which we analyzed patients who underwent ORP at our institution between 2003 and 2020. The biochemical recurrence (BCR)-free survival and overall survival (OS) rates were defined using the Kaplan-Meier method and log-rank analysis. Multivariable Cox-regression models were used to test the effect of other different factors such as preoperative PSA, Gleason score and T stage on biochemical recurrence. The Clavien-Dindo classification was used to report the complication rates. RESULTS: In total, 1040 patients were included. PNI was found in 458 (44.1%) and BCR occurred in 212 patients (20.4%) at a median follow-up of 91.2 months. After undergoing the procedure, 216 patients received adjuvant external beam radiotherapy (EBRT). Despite receiving adjuvant treatment, the BCR-free survival was still significantly shorter for PNI-positive patients (mean 32.2 vs. 62.3 months, p < 0.001). The 5- and 10-year BCR-free survival rates for patients without PNI were 90% and 81%, respectively. For the same period of time, BCR-free survival rates for patients with PNI were 75 and 63%, respectively. Therefore, PNI was a strong predictor of BCR (p < 0.001). These results remained even after controlling for established predictors of biochemical recurrence. Limitations include retrospective and single-center study design. CONCLUSION: In conclusion, despite its limitations, our study emphasizes the prognostic importance of PNI in prostate cancer patients. The results demonstrate that the presence of PNI is associated with a high risk of BCR.
PURPOSE: To explore the association between perineural invasion (PNI) and biochemical recurrence (BCR) in patients undergoing open radical prostatectomy (ORP). METHODS: A retrospective observational study was conducted, in which we analyzed patients who underwent ORP at our institution between 2003 and 2020. The biochemical recurrence (BCR)-free survival and overall survival (OS) rates were defined using the Kaplan-Meier method and log-rank analysis. Multivariable Cox-regression models were used to test the effect of other different factors such as preoperative PSA, Gleason score and T stage on biochemical recurrence. The Clavien-Dindo classification was used to report the complication rates. RESULTS: In total, 1040 patients were included. PNI was found in 458 (44.1%) and BCR occurred in 212 patients (20.4%) at a median follow-up of 91.2 months. After undergoing the procedure, 216 patients received adjuvant external beam radiotherapy (EBRT). Despite receiving adjuvant treatment, the BCR-free survival was still significantly shorter for PNI-positive patients (mean 32.2 vs. 62.3 months, p < 0.001). The 5- and 10-year BCR-free survival rates for patients without PNI were 90% and 81%, respectively. For the same period of time, BCR-free survival rates for patients with PNI were 75 and 63%, respectively. Therefore, PNI was a strong predictor of BCR (p < 0.001). These results remained even after controlling for established predictors of biochemical recurrence. Limitations include retrospective and single-center study design. CONCLUSION: In conclusion, despite its limitations, our study emphasizes the prognostic importance of PNI in prostate cancer patients. The results demonstrate that the presence of PNI is associated with a high risk of BCR.
Authors: Patricia Harnden; Michael D Shelley; Hayley Clements; Bernadette Coles; R Sandy Tyndale-Biscoe; Brian Naylor; Malcolm D Mason Journal: Cancer Date: 2007-01-01 Impact factor: 6.860
Authors: Joshua A Cohn; Pankaj P Dangle; Chihsiung E Wang; Charles B Brendler; Kristian R Novakovic; Michael S McGuire; Brian T Helfand Journal: BJU Int Date: 2014-01-22 Impact factor: 5.588
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