Influence of biopsy perineural invasion on long-term biochemical disease-free survival after radical prostatectomy.
OBJECTIVE
To investigate the influence of biopsy perineural invasion (PNI) on long-term prostate-specific antigen recurrence rates, final pathologic stage, and surgical margin status of men treated with radical prostatectomy. Radical prostatectomy offers the best chance for surgical cure when performed for organ-confined disease. However, the histologic identification of PNI on prostate biopsy has been associated with a decreased likelihood of pathologically organ-confined disease.


METHODS
Seventy-eight men with histologic evidence of PNI on biopsy underwent radical prostatectomy by a single surgeon between April 1984 and February 1995 and were compared with 78 contemporary matched (biopsy Gleason score, prostate-specific antigen level, clinical stage, age) controls without PNI. Biochemical disease-free survival and pathologic findings were compared.


RESULTS
After a mean follow-up of 7.05 +/- 2.2 years and 7.88 +/- 2.7 years (P = 0.04) for patients with biopsy PNI and controls, respectively, no significant difference in the long-term prostate-specific antigen recurrence rates was observed (P = 0.13). The final Gleason score and pathologic staging were also similar in this matched cohort. Although the numbers of neurovascular bundles resected were comparable between the groups, no difference was found in the rate of positive surgical margins identified (13% versus 10%, P = 0.62).


CONCLUSIONS
We were unable to show that PNI on needle biopsy influences long-term tumor-free survival.
O'Malley
Kiaran J
KJ
James Buchanan Brady Urological Institute and Department of Pathology, Johns Hopkins University Medical Institutions, Baltimore, Maryland 21287, USA.
Pound
Charles R
CR
Walsh
Patrick C
PC
Epstein
Jonathan I
JI
Partin
Alan W
AW
D000704:Analysis of Variance; D001707:Biopsy, Needle; D016022:Case-Control Studies; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000097:blood; D010502:Perineum; D011467:Prostate / Q000378:metabolism / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*
D017430:Prostate-Specific Antigen