Perineural invasion by prostate adenocarcinoma in needle biopsies predicts bone metastasis: Ten year data from the TROG 03.04 RADAR Trial.
Adenocarcinoma
/ complications
Aged
Biopsy, Needle
Bone Neoplasms
/ etiology
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Grading
Neoplasm Invasiveness
/ pathology
Neoplasm Metastasis
/ pathology
Peripheral Nerves
/ pathology
Prognosis
Prostate
/ pathology
Prostate-Specific Antigen
Prostatic Neoplasms
/ complications
ISUP grade
metastases
perineural invasion
prognosis
prostate adenocarcinoma
Journal
Histopathology
ISSN: 1365-2559
Titre abrégé: Histopathology
Pays: England
ID NLM: 7704136
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
05
01
2020
revised:
08
03
2020
accepted:
17
03
2020
pubmed:
15
4
2020
medline:
20
8
2021
entrez:
15
4
2020
Statut:
ppublish
Résumé
Perineural invasion (PNI) by prostatic adenocarcinoma is debated as a prognostic parameter. This study investigates the prognostic predictive value of PNI in a series of patients with locally advanced prostate cancer treated with radiotherapy and androgen deprivation using 10 years outcome data from the TROG 03.04 RADAR trial. Diagnostic prostate biopsies from 976 patients were reviewed and the presence of PNI noted. Patients were followed for 10 years according to the trial protocol or until death. The primary endpoint for the study was time to bone metastasis. Secondary endpoints included time to soft tissue metastasis, transition to castration resistance, prostate cancer-specific mortality and all-cause mortality. PNI was detected in 449 cases (46%), with 234 cases (24%) having PNI in more than one core. The presence of PNI was significantly associated with higher ISUP grade, clinical T staging category, National Comprehensive Cancer Network risk group, and percent positive biopsy cores. The cumulative probability of bone metastases according to PNI status was significant over the 10 years follow-up interval of the study (log-rank test P < 0.0001). PNI was associated with all endpoints on univariable analysis. After adjusting for baseline clinicopathological and treatment factors, bone metastasis was the only endpoint in which PNI retained its prognostic significance (hazard ratio 1.42, 95% confidence interval 1.05-1.92, P = 0.021). The association between PNI and the development of bone metastases supports the inclusion of this parameter as a component of the routine histology report. Further this association suggests that evaluation of PNI may assist in selecting those patients who should be monitored more closely during follow-up.
Substances chimiques
Prostate-Specific Antigen
EC 3.4.21.77
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
284-292Informations de copyright
© 2020 John Wiley & Sons Ltd.
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