Perineural Invasion and Risk of Lethal Prostate Cancer

Prostate cancer has a propensity to invade and grow along nerves, a phenomenon called perineural invasion (PNI). Recent studies suggest that the presence of PNI in prostate cancer has been associated with cancer aggressiveness. We investigated the association between PNI and lethal prostate cancer i...

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Veröffentlicht in:Cancer epidemiology, biomarkers & prevention Jg. 26; H. 5; S. 719
Hauptverfasser: Zareba, Piotr, Flavin, Richard, Isikbay, Masis, Rider, Jennifer R, Gerke, Travis A, Finn, Stephen, Pettersson, Andreas, Giunchi, Francesca, Unger, Robert H, Tinianow, Alex M, Andersson, Swen-Olof, Andrén, Ove, Fall, Katja, Fiorentino, Michelangelo, Mucci, Lorelei A
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.05.2017
Schlagworte:
Adult
Aged
Cohort Studies
Humans
Male
Middle Aged
Neoplasm Grading - methods
Neoplasm Invasiveness - pathology
Peripheral Nerves - pathology
Prostatic Neoplasms - pathology
ISSN:1538-7755, 1538-7755
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Zusammenfassung:Prostate cancer has a propensity to invade and grow along nerves, a phenomenon called perineural invasion (PNI). Recent studies suggest that the presence of PNI in prostate cancer has been associated with cancer aggressiveness. We investigated the association between PNI and lethal prostate cancer in untreated and treated prostate cancer cohorts: the Swedish Watchful Waiting Cohort of 615 men who underwent watchful waiting, and the U.S. Health Professionals Follow-Up Study of 849 men treated with radical prostatectomy. One pathologist performed a standardized histopathologic review assessing PNI and Gleason grade. Patients were followed from diagnosis until metastasis or death. The prevalence of PNI was 7% and 44% in the untreated and treated cohorts, respectively. PNI was more common in high Gleason grade tumors in both cohorts. PNI was associated with enhanced tumor angiogenesis, but not tumor proliferation or apoptosis. In the Swedish study, PNI was associated with lethal prostate cancer [OR 7.4; 95% confidence interval (CI), 3.6-16.6; < 0.001]. A positive, although not statistically significant, association persisted after adjustment for age, Gleason grade, and tumor volume (OR 1.9; 95% CI, 0.8-5.1; = 0.17). In the U.S. study, PNI predicted lethal prostate cancer independent of clinical factors (HR 1.8; 95% CI, 1.0, 3.3; =0.04). These data support the hypothesis that perineural invasion creates a microenvironment that promotes cancer aggressiveness. Our findings suggest that PNI should be a standardized component of histopathologic review, and highlights a mechanism underlying prostate cancer metastasis. .
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1538-7755
1538-7755
DOI:10.1158/1055-9965.EPI-16-0237