Although numerous studies have shown that perineural invasion (PNI) is linked to prostate cancer (PCa) risk, the results have been inconsistent. This study aimed to explore the association between PNI and biochemical recurrence (BCR) in patients with PCa following radical prostatectomy (RP) or radiotherapy (RT).
According to the PRISMA statement, we searched the PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI) and Wan Fang databases from inception to May 2017. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were extracted from eligible studies. Fixed or random effects model were used to calculate pooled HRs and 95% CIs according to heterogeneity. Publication bias was calculated by Begg’s test.
Ultimately, 19 cohort studies that met the eligibility criteria and that involved 13,412 patients (82-2,316 per study) were included in this meta-analysis. The results showed that PNI was associated with higher BCR rates in patients with PCa after RP (HR=1.23, 95% CI: 1.11, 1.36, p<0.001) or RT (HR=1.22, 95% CI: 1.12, 1.34, p<0.001). No potential publication bias was found among the included studies in the RP group (p-Begg = 0.124) or the RT group (p-Begg = 0.081).
This study suggests that the presence of PNI by histopathology is associated with higher risk of BCR in PCa following RP or RT, and could serve as an independent prognostic factor in patients with PCa.
Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA: a cancer journal for clinicians. 2017;67(1):7–30.
Fossati N, Karnes RJ, Cozzarini C, Fiorino C, Gandaglia G, Joniau S, Boorjian SA, Goldner G, Hinkelbein W, Haustermans K, et al. Assessing the Optimal Timing for Early Salvage Radiation Therapy in Patients with Prostate-specific Antigen Rise After Radical Prostatectomy. European urology. 2016;69(4):728–33. CrossRefPubMed
Haki Yuksel O, Urkmez A, Verit A: Can perineural invasion detected in prostate needle biopsy specimens predict surgical margin positivity in D'Amico low risk patients? Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica 2016, 88(2):89-92.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Journal of clinical epidemiology. 2009;62(10):e1–34. CrossRefPubMed
Roach M 3rd, Hanks G, Thames H Jr, Schellhammer P, Shipley WU, Sokol GH, Sandler H. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. International journal of radiation oncology, biology, physics. 2006;65(4):965–74. CrossRefPubMed
Zhu YJ, Wang YQ, Pan JH, Dong BJ, Xu F, Sha JJ, Xue W. Huang YR: [Value of perineural invasion in prostatectomy specimen in the assessment on tumor progression and prognosis]. Zhonghua wai ke za zhi [Chinese journal of surgery]. 2016;54(3):217–21.
Porcaro AB, de Luyk N, Corsi P, Sebben M, Tafuri A, Tamanini I, Processali T, Cerruto MA, Migliorini F, Brunelli M, et al. Bilateral lymph node micrometastases and seminal vesicle invasion associated with same clinical predictors in localized prostate cancer. Tumori. 2017;103(3):299–306. CrossRefPubMed
Liang D, Shi S, Xu J, Zhang B, Qin Y, Ji S, Xu W, Liu J, Liu L, Liu C, et al. New insights into perineural invasion of pancreatic cancer: More than pain. Biochimica et biophysica acta. 2016;1865(2):111–22. PubMed
Muppa P, Gupta S, Frank I, Boorjian SA, Karnes RJ, Thompson RH, Thapa P, Tarrell RF, Herrera Hernandez LP, Jimenez RE, et al. Prognostic significance of lymphatic, vascular and perineural invasion for bladder cancer patients treated by radical cystectomy. Pathology. 2017;49(3):259–66. CrossRefPubMed
DeLancey JO, Wood DP, Jr., He C, Montgomery JS, Weizer AZ, Miller DC, Jacobs BL, Montie JE, Hollenbeck BK, Skolarus TA: Evidence of perineural invasion on prostate biopsy specimen and survival after radical prostatectomy. Urology 2013, 81(2):354-357.
Jeon HG, Bae J, Yi JS, Hwang IS, Lee SE, Lee E. Perineural invasion is a prognostic factor for biochemical failure after radical prostatectomy. International journal of urology : official journal of the Japanese Urological Association. 2009;16(8):682–6. CrossRef
Reeves F, Hovens CM, Harewood L, Battye S, Peters JS, Costello AJ, Corcoran NM. Does perineural invasion in a radical prostatectomy specimen predict biochemical recurrence in men with prostate cancer? Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 2015;9(5-6):E252–5. CrossRefPubMedPubMedCentral
Ding W, Lee J, Chamberlain D, Cunningham J, Yang L, Tay J. Twelve-month prostate-specific antigen values and perineural invasion as strong independent prognostic variables of long-term biochemical outcome after prostate seed brachytherapy. International journal of radiation oncology, biology, physics. 2012;84(4):962–7. CrossRefPubMed
Jung JH, Lee JW, Arkoncel FR, Cho NH, Yusoff NA, Kim KJ, Song JM, Kim SJ, Rha KH. Significance of perineural invasion, lymphovascular invasion, and high-grade prostatic intraepithelial neoplasia in robot-assisted laparoscopic radical prostatectomy. Annals of surgical oncology. 2011;18(13):3828–32. CrossRefPubMed
Feng FY, Qian Y, Stenmark MH, Halverson S, Blas K, Vance S, Sandler HM, Hamstra DA. Perineural invasion predicts increased recurrence, metastasis, and death from prostate cancer following treatment with dose-escalated radiation therapy. International journal of radiation oncology, biology, physics. 2011;81(4):e361–7. CrossRefPubMed
Spratt DE, Zumsteg Z, Ghadjar P, Pangasa M, Pei X, Fine SW, Yamada Y, Kollmeier M, Zelefsky MJ. Prognostic importance of Gleason 7 disease among patients treated with external beam radiation therapy for prostate cancer: results of a detailed biopsy core analysis. International journal of radiation oncology, biology, physics. 2013;85(5):1254–61. CrossRefPubMed
- Perineural invasion as an independent predictor of biochemical recurrence in prostate cancer following radical prostatectomy or radiotherapy: a systematic review and meta-analysis
- BioMed Central
Neu im Fachgebiet Urologie
Meistgelesene Bücher in der Urologie
Mail Icon II