Perineural Invasion by Prostate Cancer on MR/US Fusion Targeted Biopsy is Associated with Extraprostatic Extension and Early Biochemical Recurrence after Radical Prostatectomy

In recent years, multiparametric magnetic resonance imaging (MRI) and MR/ultrasound (US) fusion targeted biopsy (TB) have become more widely adopted to aid in prostate cancer (PCa) detection. Previously, TB has been found to increase the yield of clinically significant PCa and is more likely to sample the index tumor compared to traditional 12-core extended sextant biopsies. Currently the prognostic significance of perineural invasion (PNI) when identified on TB (PNI-TB) is unknown. We identified 95 men at two tertiary referral centers who underwent TB followed by radical prostatectomy between January 2014 and January 2017. Clinical, radiological, and pathological variables were retrospectively reviewed. PNI was identified on TB in 27/95 (28.4%) patients. On multivariable logistic regression, independent predictors of extraprostatic extension were prostate specific antigen (PSA), TB maximum % core involvement, and PNI-TB (all P<.05). Furthermore, Kaplan-Meier analysis demonstrated that PNI-TB was associated with early biochemical recurrence events within 12months after prostatectomy (log rank P=.049). Given the increasing adoption of TB for PCa detection in clinical practice, PNI-TB may be useful for PCa risk stratification.

Human pathology. 2017 Jul 10 [Epub ahead of print]

Matthew Truong, Soroush Rais-Bahrami, Jeffrey W Nix, Edward M Messing, Hiroshi Miyamoto, Jennifer B Gordetsky

Department of Urology, University of Rochester Medical Center, Rochester, NY, USA., Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA., Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA., Department of Urology, University of Rochester Medical Center, Rochester, NY, USA; Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA., Department of Urology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: .