Skip to main content
Top
Published in: Annals of Surgical Oncology 8/2016

01-08-2016 | Urologic Oncology

Perineural Invasion and Lymphovascular Invasion are Associated with Increased Risk of Biochemical Recurrence in Patients Undergoing Radical Prostatectomy

Authors: Minyong Kang, MD, PhD, Jong Jin Oh, MD, PhD, Sangchul Lee, MD, PhD, Sung Kyu Hong, MD, PhD, Sang Eun Lee, MD, PhD, Seok-Soo Byun, MD, PhD

Published in: Annals of Surgical Oncology | Issue 8/2016

Login to get access

Abstract

Purpose

This study was designed to determine whether perineural invasion (PNI) and lymphovascular invasion (LVI) are independent predictors for biochemical recurrence (BCR) of prostate cancer (PCa) following radical prostatectomy (RP) in the Asian population.

Methods

The study population comprised 2394 PCa patients undergoing RP at our institution in Korea. After excluding 360 patients, we compared the baseline characteristics between the groups according to the presence of PNI or LVI and estimated BCR-free survival using the Kaplan–Meier survival. Multivariate Cox regression model was adopted to identify significant predictive factors of BCR following RP.

Results

Among 2034 patients, PNI and LVI were detected in 69.3 and 12.4 % patients, respectively. Patients with PNI or LVI had higher rates of advanced biopsy and pathological Gleason score (≥7), and higher proportions of advanced clinical and pathological T stage ≥3, extraprostatic extension, seminal vesicle invasion, and surgical margin positivity. Notably, BCR-free survival was lower in patients with PNI or LVI compared with that in patients without these markers and lower in patients with both markers compared with that in other populations of patients. Moreover, PNI (hazard ratio [HR] = 2.11) and LVI (HR = 1.57) were significant predictors of BCR. The presence of the two markers was associated with a higher risk of BCR (HR = 4.60) compared with the presence of either marker alone (HR = 3.47).

Conclusions

PNI and LVI are adverse pathologic parameters and independent predictors for BCR, and the concurrent presence of PNI and LVI resulted in poorer outcomes for BCR in PCa patients who underwent RP.
Appendix
Available only for authorised users
Literature
1.
go back to reference Rosenbaum E, Partin A, Eisenberger MA. Biochemical relapse after primary treatment for prostate cancer: studies on natural history and therapeutic considerations. J Natl Compr Cancer Netw. 2004;2(3):249–56. Rosenbaum E, Partin A, Eisenberger MA. Biochemical relapse after primary treatment for prostate cancer: studies on natural history and therapeutic considerations. J Natl Compr Cancer Netw. 2004;2(3):249–56.
4.
go back to reference Katz B, Srougi M, Dall’Oglio M, Nesrallah AJ, Sant’anna AC, Pontes J, Jr., et al. Perineural invasion detection in prostate biopsy is related to recurrence-free survival in patients submitted to radical prostatectomy. Urol Oncol. 2013;31(2):175-9. doi:10.1016/j.urolonc.2010.11.008.CrossRefPubMed Katz B, Srougi M, Dall’Oglio M, Nesrallah AJ, Sant’anna AC, Pontes J, Jr., et al. Perineural invasion detection in prostate biopsy is related to recurrence-free survival in patients submitted to radical prostatectomy. Urol Oncol. 2013;31(2):175-9. doi:10.​1016/​j.​urolonc.​2010.​11.​008.CrossRefPubMed
5.
go back to reference Reeves F, Hovens CM, Harewood L, Battye S, Peters JS, Costello AJ, et al. Does perineural invasion in a radical prostatectomy specimen predict biochemical recurrence in men with prostate cancer? Can Urol Assoc J. 2015;9(5–6):E252-5. doi:10.5489/cuaj.2619.CrossRefPubMedPubMedCentral Reeves F, Hovens CM, Harewood L, Battye S, Peters JS, Costello AJ, et al. Does perineural invasion in a radical prostatectomy specimen predict biochemical recurrence in men with prostate cancer? Can Urol Assoc J. 2015;9(5–6):E252-5. doi:10.​5489/​cuaj.​2619.CrossRefPubMedPubMedCentral
8.
go back to reference Mitsuzuka K, Narita S, Koie T, Kaiho Y, Tsuchiya N, Yoneyama T, et al. Lymphovascular invasion is significantly associated with biochemical relapse after radical prostatectomy even in patients with pT2N0 negative resection margin. Prostate Cancer Prostatic Dis. 2015;18(1):25–30. doi:10.1038/pcan.2014.40.CrossRefPubMed Mitsuzuka K, Narita S, Koie T, Kaiho Y, Tsuchiya N, Yoneyama T, et al. Lymphovascular invasion is significantly associated with biochemical relapse after radical prostatectomy even in patients with pT2N0 negative resection margin. Prostate Cancer Prostatic Dis. 2015;18(1):25–30. doi:10.​1038/​pcan.​2014.​40.CrossRefPubMed
10.
go back to reference Epstein JI, Allsbrook WC, Jr., Amin MB, Egevad LL, Committee IG. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol. 2005;29(9):1228–42. Epstein JI, Allsbrook WC, Jr., Amin MB, Egevad LL, Committee IG. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol. 2005;29(9):1228–42.
12.
go back to reference Magi-Galluzzi C, Evans AJ, Delahunt B, Epstein JI, Griffiths DF, van der Kwast TH, et al. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 3: extraprostatic extension, lymphovascular invasion and locally advanced disease. Mod Pathol. 2011;24(1):26–38. doi:10.1038/modpathol.2010.158. Magi-Galluzzi C, Evans AJ, Delahunt B, Epstein JI, Griffiths DF, van der Kwast TH, et al. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 3: extraprostatic extension, lymphovascular invasion and locally advanced disease. Mod Pathol. 2011;24(1):26–38. doi:10.​1038/​modpathol.​2010.​158.
13.
go back to reference Stephenson AJ, Kattan MW, Eastham JA, Dotan ZA, Bianco FJ, Jr., Lilja H, et al. Defining biochemical recurrence of prostate cancer after radical prostatectomy: a proposal for a standardized definition. J Clin Oncol. 2006;24(24):3973–8. doi:10.1200/JCO.2005.04.0756.CrossRefPubMed Stephenson AJ, Kattan MW, Eastham JA, Dotan ZA, Bianco FJ, Jr., Lilja H, et al. Defining biochemical recurrence of prostate cancer after radical prostatectomy: a proposal for a standardized definition. J Clin Oncol. 2006;24(24):3973–8. doi:10.​1200/​JCO.​2005.​04.​0756.CrossRefPubMed
16.
go back to reference Jung JH, Lee JW, Arkoncel FR, Cho NH, Yusoff NA, Kim KJ, et al. Significance of perineural invasion, lymphovascular invasion, and high-grade prostatic intraepithelial neoplasia in robot-assisted laparoscopic radical prostatectomy. Ann Surg Oncol. 2011;18(13):3828–32. doi:10.1245/s10434-011-1790-4.CrossRefPubMed Jung JH, Lee JW, Arkoncel FR, Cho NH, Yusoff NA, Kim KJ, et al. Significance of perineural invasion, lymphovascular invasion, and high-grade prostatic intraepithelial neoplasia in robot-assisted laparoscopic radical prostatectomy. Ann Surg Oncol. 2011;18(13):3828–32. doi:10.​1245/​s10434-011-1790-4.CrossRefPubMed
17.
20.
go back to reference Ciftci S, Yilmaz H, Ciftci E, Simsek E, Ustuner M, Yavuz U, et al. Perineural invasion in prostate biopsy specimens is associated with increased bone metastasis in prostate cancer. Prostate. 2015;75(15):1783–9. doi:10.1002/pros.23067.CrossRefPubMed Ciftci S, Yilmaz H, Ciftci E, Simsek E, Ustuner M, Yavuz U, et al. Perineural invasion in prostate biopsy specimens is associated with increased bone metastasis in prostate cancer. Prostate. 2015;75(15):1783–9. doi:10.​1002/​pros.​23067.CrossRefPubMed
Metadata
Title
Perineural Invasion and Lymphovascular Invasion are Associated with Increased Risk of Biochemical Recurrence in Patients Undergoing Radical Prostatectomy
Authors
Minyong Kang, MD, PhD
Jong Jin Oh, MD, PhD
Sangchul Lee, MD, PhD
Sung Kyu Hong, MD, PhD
Sang Eun Lee, MD, PhD
Seok-Soo Byun, MD, PhD
Publication date
01-08-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 8/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5153-z

Other articles of this Issue 8/2016

Annals of Surgical Oncology 8/2016 Go to the issue