Perineural Invasion Linked to Biochemical Recurrence After Prostatectomy

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Perineural invasion (PNI) is an independent predictor of biochemical recurrence after radical prostatectomy in patients with prostate cancer, according to a study presented at the NCCN 2022 Annual Conference.

PNI was associated with unfavorable histological characteristics and lower biochemical recurrence-free survival, researchers found.

“Patients in intermediate and high risk groups are more likely to present with perineural invasion and should be considered for treatment strategies according to this risk,” said study author Jose Alfonso Leiva Centeno, MD, of Sanatorio Allende in Cordoba, Argentina.


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To investigate the clinical importance of PNI, Dr Leiva Centeno and colleagues analyzed 116 patients who underwent radical prostatectomy plus pelvic lymphadenectomy between July 2010 and December 2019.

At a mean follow-up of 43 months, 75% of patients had PNI, and 36% had biochemical recurrence. Biochemical recurrence was significantly associated with the presence of PNI (P <.001), and PNI was significantly associated with lower biochemical recurrence-free survival (P <.01).

Patients with PNI had higher mean prostate-specific antigen (PSA) levels at diagnosis and worse presurgical indicators, such as International Society of Urologic Pathologists (ISUP) grade, D’Amico risk group, and number of positive cores. Patients with PNI also had worse postsurgical variables, such as ISUP grade, positive surgical margins, post-surgical PSA, and the need for additional treatment.

However, in a multivariate analysis, only a D’Amico risk group of 2 or higher was significantly associated with PNI (odds ratio, 5.25; 95% CI, 1.767-15.606).

In another multivariate analysis, PNI was an independent predictor of biochemical recurrence (hazard ratio, 4.07; 95% CI, 1.038-15.953).

“Prospective and controlled studies are necessary to verify these results,” Dr Leiva Centeno said.

Read more of Cancer Therapy Advisor’s coverage of NCCN 2022 by visiting the conference page.

Reference

Leiva Centeno JA, Orbe Villota P, de Benito JJ, et al. Clinical implication of perineural invasion in patients treated with radical prostatectomy for prostate cancer. Presented at NCCN 2022 Annual Conference; March 31 – April 2, 2022. Abstract CLO22-039.



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