The significance of perineureal invasion and prostate specific antigen for relapse after radical prostatectomy

Samed Jagodić, Šefik Hasukić, Safet Omerović, Rasim Agić, Zoran Manojlović, Alemdar Sulejmanović, Zijad Selimović, Haris Đug, Zlatko Avdić, Emir Softić, Denijal Tulumović, Jasminka Mustedanagić-Mujanović

Abstract


Introduction: Prognostic significance of prostate cancer perineural invasion after radical prostatectomy and prostate specific antigen (PSA) is not completely understood predicting factor for recurrence or progression of the disease, regardless of the kind and consequences of treatment.
Objective: To analyze the relation between prostate cancer perineural invasion after radical prostatectomy and PSA concentration in men with varying degrees of prostate cancer after radical prostatectomy.

Subjects and Methods: The study included 145 patients divided into two groups, the first (n = 104) men, average age 64.59 ± 6.12 years (50-75), with preoperative PSA ≤ 10 ng / ml, and the second (n = 41) men, average age 64.35 ± 6.39 years (49-77), with post-operative PSA> 10 ng / ml. PSA concentration was measured with the appliance Architect ci 8200 at the Department of Laboratory Medicine, (optimal value is PSA of 0.5-4 ng / ml). Indication for operative treatment was biopsy confirmation of prostate cancer and PSA. Biopsy and postoperative histopathological findings were made at the Department of Pathology, Clinical Center Tuzla, and the results presented by TNM 2002 classification.

Results: The average recorded values ​​of PSA were 5:40 ± 1.93 ng / ml (1.54-9.4) versus 13:19 ± 11.2 ng / ml (10.05-18.2) (p = 0.00023). Postoperative increase of PSA was recorded in 34 (23.5%) patients. The value of preoperative PSA had a significant impact on recurrence (p = 0.001). Perineural prostate invasion was registered in 24 (16.6%) patients. The occurrence of prostate cancer perineural invasion was a significant predictor for recurrence (p = 0.025). Patients with registered prostate cancer perineural invasion had significantly higher PSA compared to patients who did not have registered prostate cancer perineural invasion (p = 0.029).

Conclusions:Preoperative PSA and perineural invasion are a significant predictor for recurrence of prostate cancer after radical prostatectomy.

Keywords: prostate cancer, perineural invasion (PNI), prostate specific antigen (PSA).

 


Keywords


prostate cancer, perineural invasion (PNI), prostate specific antigen (PSA)

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DOI: 10.5457/ams.v45i1-2.399