Actas Urol Esp (Engl Ed). 2022 Mar 05. pii: S2173-5786(22)00011-7. [Epub ahead of print]
INTRODUCTION AND OBJECTIVES: This study aims to investigate the relationship between perineural invasion (PNI) in targeted (TBx) and/or systematic (SBx) prostate needle biopsy and adverse pathological features of prostate cancer (PCa) in prostatectomy specimens.MATERIALS AND METHODS: A total of 95 male patients who underwent transperineal TBx and/or concomitant SBx subsequently treated with robot-assisted radical prostatectomy for PCa between October 2015 and June 2020 were included. The performance of PNI as a classification test (sensitivity, specificity, positive and negative predictive values) and its correlation with clinically significant PCa, surgical margin positivity, extraprostatic extension, and seminal vesicle invasion in prostatectomy were computed.
RESULTS: The median age of the patients was 65 (60-70) years. TBx and concomitant SBx were performed in 78 (82.1%) patients, while 16 (16.8%) patients underwent SBx alone and one (1.1%) patient underwent TBx alone. The frequency of PNI in TBx and SBx was 17 (21.5%) and 32 (34.0%), respectively. The specificity/negative predictive values of PNI for surgical margin positivity, extraprostatic extension, and seminal vesicle invasion were 79.7/88.7%, 92.5/79.0%, and 83.3/96.8%, in TBx, and 71.1/87.1%, 80.7/74.2%, and 69.5/91.9%, in SBx, respectively. There was also a statistically significant correlation between PNI in biopsy and surgical margin positivity, extraprostatic extension, and seminal vesicle invasion in prostatectomy as well as the ISUP grade group and pT stage.
CONCLUSIONS: The absence of PNI in prostate needle biopsy may predict localized PCa with a pT stage ≤ 2c and negative surgical margins in contrast to its presence which appears to be an indicator of unfavorable factors in final pathology.
Keywords: Biopsia de próstata por fusión RMmp/ecografía; Extensión extraprostática; Extraprostatic extension; Invasión perineural; Invasión vesículas seminales; Perineural invasion; Prostatectomía radical; Radical prostatectomy; Seminal vesicle invasion; mpMRI/TRUS fusion prostate biopsy