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Perineurial invasion. 1 out of 10 samples cancerous. Treatment?
Prostate Cancer | Last Active: Jun 5 8:56pm | Replies (25)Comment receiving replies
These are the kinds of studies that are not very interesting. They only look at favorable gleason scores at biopsy and see if PNI has an effect on upgrading, i.e., that pattern 4 was missed at biopsy. It does not say that PNI in the pathology has any independent effect on outcomes.
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You’re correct, it does not say that; it does say that a finding of PNI represents a disease that is more diffuse throughout the gland, thereby making the Gleason score derived from the biopsy more of a ‘truer’ one….in other words, the urologist can’t miss!
The outcomes are really a function of the Gleason scores, don’t you think? A poorer outcome could occur, let’s say, if a surgeon goes in thinking his patient is a G3+4 and post op pathology makes it a G4+3 or G4+4.
Would he/she have been more careful at dissection? Did they leave what they thought was benign tissue and now would have taken it out in retrospect? I don’t have the answers.
But since PNI does represent more widespread, diffuse disease, EPE and broken capsules could result from this and ‘possibly’ have a negative effect on outcomes. It’s not the PNI itself (like cribriform or IDC), but what its presence signifies.
Phil