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The clinical significance of perineural invasion in patients with de novo metastatic prostate cancer.

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资源类型：
Pubmed体系：
作者：
Zhao J[1] ; Chen J[1] ; Zhang M[2] ; Tang X[3] ; Sun G[1] ; Zhu S[1] ; Liu J[1] ; Zhang H[1] ; Zhang X[1] ; Yin X[2] ; Zhao P[1] ; Zhu X[1] ; Ni Y[1] ; Dai J[1] ; Shen P[1] ; Chen N[2,*1] ; Zeng H[1,*1] ;
机构： [1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China [2]Department of Pathology, West China Hospital, Sichuan University, Chengdu, China [3]Department of Oncology, West China Hospital, Sichuan University, Chengdu, China
出处：
DOI： 10.1111/andr.12578
ISSN：

关键词： metastatic prostate cancer perineural invasion prognosis

摘要：
The clinical value of perineural invasion (PNI) in patients with localized prostate cancer (PCa) is widely explored. However, its role in metastatic PCa (mPCa) remains unknown. We aim to investigate the clinical significance of PNI in patients with mPCa. Data of 515 mPCa patients between 2012 and 2018 were retrospectively studied. PNI and its intensity were identified by prostate biopsy. The prognostic value of PNI was evaluated by Kaplan-Meier curves and Cox proportional-hazards model. Perineural invasion was detected in 170/515 (33.0%) cases. Among them 73/170 (42.9%) and 97/170 (57.1%) harbored unifocal PNI (uni-PNI) and multifocal PNI (multi-PNI), respectively. Compared to patients without PNI, those with PNI had statistically shorter castration-resistant PCa-free survival (CFS) and numerically shorter overall survival (OS) (mCFS: 15.4- vs. 18.5-Mo, p = 0.015; mOS: 63.8- vs. 71.4-Mo, p = 0.108). Patients harboring multi-PNI were associated with poorer clinical outcomes than those with uni-PNI (mCFS: 12.4- vs. 18.0-Mo, p = 0.040; mOS: 39.7-Mo vs. NR, p = 0.018) or those without PNI (mCFS: 12.4- vs. 18.5-Mo, p = 0.002; mOS: 39.7- vs. 71.4-Mo, p = 0.002). Totally, neither uni-PNI nor multi-PNI was an independent risk factor impacting survival outcomes in multivariate analyses. While remarkably, for patients with favorable/intermediate-risk mPCa, multi-PNI was an independent adverse prognosticator for both CFS and OS (CFS: HR: 1.705, 95% CI: 1.029-2.825, p = 0.038; OS: HR: 3.294, 95% CI: 1.464-7.413, p = 0.004). This study filled the blank of the clinical significance of PNI in mPCa. We found that multi-PNI could distinguish men with relatively poor prognosis from patients initially regarded as with favorable survival outcomes by other prognosticators, and thus, avoid disease underestimation in this group of patients. Our finding would help physicians have a deeper understanding of the heterogeneity of mPCa and make better individualized therapeutic strategy. © 2019 American Society of Andrology and European Academy of Andrology.

基金：
National Natural Science Foundation of China (NSFC 81672547, 81402110, and 81272820); Science and Technology Support Program of Sichuan Province (2015SZ0230-3); and The 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University.
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2019]版：
大类 | 2 区 医学
小类 | 1 区 男科学
最新[2023]版：
大类 | 2 区 医学
小类 | 1 区 男科学
第一作者：
第一作者机构： [1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
共同第一作者：
通讯作者：
通讯机构： [1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China [2]Department of Pathology, West China Hospital, Sichuan University, Chengdu, China [*1]West China Hospital, Sichuan University, Chengdu 610041, China
推荐引用方式(GB/T 7714)：
Zhao J,Chen J,Zhang M,et al.The clinical significance of perineural invasion in patients with de novo metastatic prostate cancer.[J].Andrology.2019,7(2):184-192.doi:10.1111/andr.12578.
APA：
Zhao J,Chen J,Zhang M,Tang X,Sun G...&Zeng H.(2019).The clinical significance of perineural invasion in patients with de novo metastatic prostate cancer..Andrology,7,(2)
MLA：
Zhao J,et al."The clinical significance of perineural invasion in patients with de novo metastatic prostate cancer.".Andrology 7..2(2019):184-192

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