Prediction of Perineural Invasion and Its Prognostic Value in Patients with Prostate Cancer
이준택, 이승수, 윤창진, 전병주, 김정만, 하홍구, 이완, 정문기,
소속 상세정보
이준택 ( Lee Jun-Taik )
부산성모병원 비뇨기과
이승수 ( Lee Seung-Soo )
부산대학교 의학전문대학원 비뇨기과학교실
윤창진 ( Yun Chang-Jin )
부산대학교 의학전문대학원 비뇨기과학교실
전병주 ( Jeon Byung-Joo )
메리놀병원 비뇨기과
김정만 ( Kim Jung-Man )
부산대학교 의과대학 비뇨기과학교실
하홍구 ( Ha Hong-Koo )
부산대학교 의학전문대학원 비뇨기과학교실
이완 ( Lee Wan )
부산대학교 의학전문대학원 비뇨기과학교실
정문기 ( Chung Moon-Kee )
부산대학교 의학전문대학원 비뇨기과학교실
KMID : 0358320100510110745
Abstract
Purpose The prognostic significance of perineural invasion by prostate cancer is debated. We investigated the association between perineural invasion and clinicopathological factors and the effect of perineural invasion on survival in patients with prostate cancer.
Materials and Methods A total of 361 patients with prostate cancer without any neoadjuvant therapies prior to surgery from 1999 to 2010 were analyzed retrospectively. Whole-mount sections of surgical specimens from all patients who underwent radical prostatectomy were evaluated. Positive perineural invasion was defined as infiltration of cancer cells in the perineurium or neural fascicles. The relationship of perineural invasion with clinicopathological features and prognosis of prostate cancer was studied. We also researched preoperative factors that were associated with perineural invasion.
Results Perineural invasion in a prostatectomy specimen (PNIp) was positive in 188 of 361 patients (52.1%). In the multivariate analysis of the preoperative variables, PNIp was related to the primary Gleason grade (p=0.020), the number of positive cores (p=0.008), and the percentage of tumor cells in positive cores (p=0.021), but not to perineural invasion of a prostate biopsy. In the evaluation between PNIp and pathologic findings of the prostatectomy specimen, PNIp was related to the Gleason score (p=0.010), T-stage (p=0.015), and lymphovascular invasion (p=0.019). However, by multivariate analysis, the PNIp was not an independent prognostic factor of biochemical serum recurrence (p=0.364) or cancer-specific survival (p=0.726).
Conclusions PNIp was significantly related to biologically aggressive tumor patterns but was not a prognostic factor for biochemical serum PSA recurrence or cancer-specific survival in patients with prostate cancer.
키워드
Neoplasm invasiveness; Peripheral nerves; Prognosis; Prostatic neoplasms
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