Association of Perineural Invasion of Adenocarcinoma in Prostate Biopsy with Pathological and Clinical Outcomes

Abstract

Objective: This study aims to evaluate the association between perineural invasion and pathological stage, including extraprostatic extension, and its impact on prognosis. Materials and Methods: A total of 149 men diagnosed with prostatic adenocarcinoma by magnetic resonance imaging/ultrasound (MRI-US) fusion-guided biopsy and radical prostatectomy between July 1, 2018 and December 31, 2019 at Siriraj Hospital were identified. Their pathological, clinical, and radiological findings were retrospectively analyzed. Patients with and without perineural invasion were compared using descriptive and inferential statistics. Results: Perineural invasion was identified in 87 of 149 patients (58.4%) and showed no significant association with baseline features (p > 0.05). However, perineural invasion was significantly associated with higher pathological T stage (pT2, pT3a, pT3b) (p < 0.001), including extraprostatic extension (pT3 disease) in univariate analysis. Multivariate analysis demonstrated a notable correlation between the pathological T stage and 2-year disease-free survival (p < 0.001). Conclusion: Perineural invasion should be carefully identified and reported in prostate biopsy specimens due to its significant relationship with the pathological T stage, including extraprostatic extension.

Keywords

• prostate cancer
• prostatic adenocarcinoma
• image-guided biopsy
• perineural invasion
• pathological stage