Perineural invasion on prostate needle biopsy does not predict biochemical failure following brachytherapy for prostate cancer.
OBJECTIVE
To determine if the presence of perineural invasion (PNI) predicts biochemical recurrence in patients who underwent low-dose-rate brachytherapy for the treatment of localized prostate cancer.


METHODS
A retrospective case control matching study was performed. The records of 651 patients treated with brachytherapy between 1996 and 2003 were reviewed. Sixty-three of these patients developed biochemical failure. These sixty-three patients were then matched in a one-to-one ratio to patients without biochemical failure, controlling for biopsy Gleason score, clinical stage, initial prostate-specific antigen, age, and the use of androgen deprivation. The pathology of the entire cohort was then reviewed for evidence of perineural invasion on initial prostate biopsy specimens. The biochemical relapse free survival rates for these two groups were compared.


RESULTS
Cases and controls were well matched, and there were no significant differences between the two groups in age, Gleason grade, clinical stage, initial prostate-specific antigen, and the use of androgen deprivation. PNI was found in 19 (17%) patients. There was no significant difference in the rates of PNI between cases and controls, 19.6% and 14.3% respectively (p = 0.45). PNI did not correlate with biochemical relapse free survival (p = 0.40).


CONCLUSIONS
Perineural invasion is not a significant predictor of biochemical recurrence in patients undergoing brachytherapy for prostate cancer.
Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Christopher J
CJ
Weight
Jay P
JP
Ciezki
Chandana A
CA
Reddy
Ming
M
Zhou
Eric A
EA
Klein
D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001918:Brachytherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011467:Prostate / Q000294:innervation / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy; D012044:Regression Analysis; D015996:Survival Rate
D017430:Prostate-Specific Antigen