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01-12-2011 | Urologic Oncology

Significance of Perineural Invasion, Lymphovascular Invasion, and High-Grade Prostatic Intraepithelial Neoplasia in Robot-Assisted Laparoscopic Radical Prostatectomy

Authors: Jae Hung Jung, MD, Jae Won Lee, MD, Francis Raymond P. Arkoncel, MD, Nam Hoon Cho, MD, PhD, Noor Ashani Md Yusoff, MD, Kwang Jin Kim, MD, PhD, Jae Mann Song, MD, PhD, Sung Jin Kim, MD, PhD, Koon Ho Rha, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2011

Abstract

Background

Recently, more detailed histopathological variables such as perineural invasion (PNI), lymphovascular invasion (LVI), and high-grade prostatic intraepithelial neoplasia (HGPIN) have been investigated as prognostic factors for adverse pathologic findings on the radical prostatectomy specimen. We aim to determine whether these pathological factors are associated with adverse pathologic features after robot-assisted laparoscopic radical prostatectomy (RALP).

Methods

All 407 patients who underwent RALP with pelvic lymphadenectomy between July 2005 and December 2009 were analyzed, retrospectively. We investigated the association of these three pathological parameters with adverse pathological findings in RALP specimen and biochemical recurrence using Kaplan-Meier analysis with log-rank test and a multivariate Cox proportional hazard model.

Results

The PNI and LVI were significantly associated with a higher pathological stage, a higher pathological Gleason score, a higher tumor volume in RALP specimen, a higher frequency of positive surgical margins, and a higher frequency of seminal vesicle invasion. In addition, PNI correlated with preoperative PSA, clinical stage, and Gleason score on needle biopsy. However, the HGPIN was not significantly associated with the clinicopathological characteristics studied. Using log-rank test, presence of PNI (P < 0.001) increases the probability of biochemical recurrence. On multivariate analysis, all three pathological parameters were not significantly correlated with biochemical recurrence.

Conclusion

Although presence of PNI and LVI in RALP specimen correlated with multiple adverse clinicopathological factors, it did not predict biochemical recurrence, thus limiting its clinical usefulness. HGPIN was not significantly associated with the clinicopathological characteristics studied.

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Title: Significance of Perineural Invasion, Lymphovascular Invasion, and High-Grade Prostatic Intraepithelial Neoplasia in Robot-Assisted Laparoscopic Radical Prostatectomy
Authors: Jae Hung Jung, MD
Jae Won Lee, MD
Francis Raymond P. Arkoncel, MD
Nam Hoon Cho, MD, PhD
Noor Ashani Md Yusoff, MD
Kwang Jin Kim, MD, PhD
Jae Mann Song, MD, PhD
Sung Jin Kim, MD, PhD
Koon Ho Rha, MD, PhD
Publication date: 01-12-2011
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 13/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-011-1790-4

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Significance of Perineural Invasion, Lymphovascular Invasion, and High-Grade Prostatic Intraepithelial Neoplasia in Robot-Assisted Laparoscopic Radical Prostatectomy

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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