Correlation of perineural invasion on radical prostatectomy specimens withother pathologic prognostic factors and PSA failure

Objective: The aim of this study is to evaluate the relationship between pe rineural invasion (PNI), and other pathologic prognostic factors in radical retropubic prostatectomy (RRP), specimens and also to assess, the role of PNI in prostate-specific antigen (PSA) recurrence after RRP Method; 191 consecutive patients, had undergone RRP for clinically localize d prostate cancer between 1992 and 2000. PNI in RRP specimens and its relat ion to histopathologic stage and surgical margins, is, investigated retrosp ectively. PNI, histopathologic stage, surgical margin status, Gleason score and PSA parameters were used as variables in multivariate analysis for rec urrence. Results: PNI is correlated statistically significantly with histopathologic stage, positive surgical margins, specimen Gleason score and recurrence. M ean time to failure was earlier in patients with PNI than patients, without PNI (56 vs. 73 months, log-rank 15.67, p <0.001). Lymph node involvement, positive surgical margins and PNI remained as independent predictors of rec urrence in multivariate analysis. All patients with PNI, positive surgical margins and lymph node metastasis failed in 6 months. Conclusion: PNI is an important prognostic factor that should be taken into consideration in clinical patient management and follow-up after RRP The p resence of PNI together with positive surgical margins and lymph node metas tasis may warrant early adjuvant treatment. Copyright (C) 2001 S. Karger AG , Basel.