Perineural invasion is a prognostic factor for biochemical failure after radical prostatectomy.
OBJECTIVE
To identify the prognostic significance of lymphovascular invasion (LVI) and perineural invasion (PNI) in patients undergoing radical prostatectomy for prostate cancer.


METHODS
Overall, 237 patients who had undergone radical prostatectomy for prostate cancer between 1995 and 2004 were analyzed for all clinical and pathological factors. The influence of these two pathological features on biochemical failure-free survival was evaluated by univariate and multivariate analysis.


RESULTS
Lymphovascular and perineural invasion were identified in 41 (17.2%) and 100 (42.0%) patients, respectively. LVI and PNI were significantly associated with the preoperative prostate-specific antigen (PSA) level, a higher PSA density, a higher pathological stage, a higher Gleason score, a higher frequency of extracapsular extension, a higher frequency of seminal vesicle invasion, and a higher frequency of a positive resection margin. Positive resection margins (P = 0.001) and perineural invasion (P = 0.011) were identified as independent factors associated with biochemical failure-free survival by the multivariate analysis.


CONCLUSIONS
In this series, PNI was associated with established parameters of biologically aggressive disease, and was an important prognostic factor for biochemical failure-free survival in patients undergoing radical prostatectomy. This finding supports routine evaluation of the PNI status in radical prostatectomy specimens and suggests that patients with PNI should be more closely followed after surgery.
Jeon
Hwang Gyun
HG
Department of Urology, Seoul National University Hospital, Seoul, Korea.
Bae
Jungbum
J
Yi
Jun-Seok
JS
Hwang
In Sik
IS
Lee
Sang Eun
SE
Lee
Eunsik
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009423:Nervous System Neoplasms / Q000473:pathology; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery*; D017211:Treatment Failure; D019043:Vascular Neoplasms / Q000473:pathology
D017430:Prostate-Specific Antigen