@Article{,
AUTHOR = {Carlos H. Martinez, Andrew K. Williams, Joseph L. Chin, 
Larry Stitt, Jonathan I. Izawa},
TITLE = {Perineural invasion and TRUS findings are complementary in predicting prostate cancer biology},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {20},
YEAR = {2013},
NUMBER = {2},
PAGES = {6696--6701},
URL = {http://www.techscience.com/CJU/v20n2/61625},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> Clinical variables with more accuracy to predict biologically insignificant prostate cancer are needed. We evaluated the combination of transrectal ultrasound-guided biopsy of the prostate (TRUSBx) pathologic and radiologic findings in their ability to predict the biologic potential of each prostate cancer.<br/>
<b>Materials and methods:</b> A total of 1043 consecutive patients who underwent TRUSBx were reviewed. Using pathologic criteria, patients with prostate cancer (n = 529) and those treated with radical prostatectomy (RP) (n = 147) were grouped as: “insignificant” (Gleason score ≤ 6, prostate-specific antigen (PSA) density ≤ 0.15 ng/mL, tumor in ≤ 50% of any single core, and < 33% positive cores) and “significant” prostate cancer. TRUSBx imaging and pathology results were compared with the RP specimen to identify factors predictive of “insignificant” prostate cancer.<br/>
<b>Results:</b> TRUSBx pathology results demonstrated perineural invasion in 36.4% of “significant” versus 5.4% of “insignificant” prostate cancers (p < 0.01), and pathologic invasion of periprostatic tissue in 7% of significant versus 0% of insignificant prostate cancers (p < 0.01). TRUS findings concerning for neoplasia were associated with significant tumors (p < 0.01). Multivariable analysis demonstrated that perineural invasion in the biopsy specimen (p = 0.03), PSA density (p = 0.02), and maximum tumor volume of any core (p = 0.02) were independently predictive of a significant prostate cancer.<br/>
<b>Conclusions:</b> TRUS findings concerning measurable tumor and perineural invasion in TRUSBx specimens appear to be complementary to Epstein’s pathologic criteria and should be considered to aid in determining whether a prostate cancer is organ-confined and more likely to be biologically insignificant.},
DOI = {}
}