title: Does perineural invasion in a radical prostatectomy specimen predict biochemical recurrence in men with prostate cancer?
abstract: BACKGROUND
  The ability of perineural invasion (PNI) in radical prostatectomy (RP) specimens to predict biochemical recurrence (BCR) is unclear. This study investigates this controversial question in a large cohort.
  
  
  METHODS
  A retrospective analysis was undertaken of prospectively collected data from 1497 men who underwent RP (no neoadjuvant therapy) for clinically localized prostate cancer. The association of PNI at RP with other clinicopathological parameters was evaluated. The correlation of clinicopathological factors and BCR (defined as prostate-specific antigen [PSA] >0.2 ng/mL) was investigated with univariable and multivariable Cox regression analysis in 1159 men.
  
  
  RESULTS
  PNI-positive patients were significantly more likely to have a higher RP Gleason score, pT3 disease, positive surgical margins, and greater cancer volume (p < 0.0005). The presence of PNI significantly correlated with BCR on univariable (hazard ratio 2.30, 95% confidence interval 1.50-3.55, p < 0.0005), but not multivariable analysis (p = 0.602). On multivariable Cox regression analysis the only independent prognostic factors were preoperative PSA, RP Gleason score, pT-stage, and positive surgical margin status. These findings are limited by a relatively short follow-up time and retrospective study design.
  
  
  CONCLUSIONS
  PNI at RP is not an independent predictor of BCR. Therefore, routine reporting of PNI is not indicated. Future research should be targeted at the biology of PNI to increase the understanding of its role in prostate cancer progression.
authors.affiliation: Department of Urology and Surgery, University of Melbourne, The Royal Melbourne Hospital, Australia;
authors.forename: Fairleigh
authors.initials: F
authors.lastname: Reeves
authors.affiliation: Department of Urology and Surgery, University of Melbourne, The Royal Melbourne Hospital, Australia; ; Australian Prostate Cancer Research Centre Epworth, Richmond, Australia;
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Hovens
authors.affiliation: Department of Urology and Surgery, University of Melbourne, The Royal Melbourne Hospital, Australia; ; Australian Prostate Cancer Research Centre Epworth, Richmond, Australia;
authors.forename: Laurence
authors.initials: L
authors.lastname: Harewood
authors.affiliation: TissuPath Pty Ltd, Mount Waverley, Australia.
authors.forename: Shane
authors.initials: S
authors.lastname: Battye
authors.affiliation: Department of Urology and Surgery, University of Melbourne, The Royal Melbourne Hospital, Australia; ; Australian Prostate Cancer Research Centre Epworth, Richmond, Australia;
authors.forename: Justin S
authors.initials: JS
authors.lastname: Peters
authors.affiliation: Department of Urology and Surgery, University of Melbourne, The Royal Melbourne Hospital, Australia; ; Australian Prostate Cancer Research Centre Epworth, Richmond, Australia;
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Costello
authors.affiliation: Department of Urology and Surgery, University of Melbourne, The Royal Melbourne Hospital, Australia; ; Australian Prostate Cancer Research Centre Epworth, Richmond, Australia;
authors.forename: Niall M
authors.initials: NM
authors.lastname: Corcoran