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Looking for advice on Perineural invasion present
I had my radical prostatectomy 6 months ago. Final diagnosis included Perineural invasion present, Carcinoma focally extends to right apical resection tissue edge and High grade prostatic intraepithelial neoplasion (HGPIN). Tertiary pattern 5 is present with a gleason of 4 + 3. Sounds bad. Not sure how bad. Anybody out there with some of the same type of diagnosis? I am looking for interpretation and any advice on next steps?
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PNI is no longer considered to be an indication of aggressivess; it merely suggests the amount and lateral spread inside the gland.
That said, it does tell you that the tumor burden is larger and treatment may change accordingly.
Phil
PNI and HGPIN are nothing to eorry about. But the phrase « Carcinoma focally extends to right apical resection tissue edge« I believe indicates a focal positive margin. Have you spoken with your team about this?
Good question. I noted it in my biopsy report, and my physician didn't even address it (I forgot to ask him while there for the post-biopsy appointment). In my follow-up pre-op appointment, and in my post-op surgical pathology report review, I asked both times about PNI. My urologist said, with a near-flippant tone: "don't worry about it, everyone has some degree of PNI, it doesn't mean anything to the bigger picture." So...if there are any physicians following this conversation, please weigh-in on your opinion of the significance of PNI and how it impacts any outcome or treatment plan.
My surgeon/urologist told me that PNI is still being debated. No defined conclusions.
He’s correct - even though his tone is not very laudable. Don’t worry!
Phil