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The predictive value of PNI for extracapsular extension has decreased over time because of a downward stage migration driven largely by early detection efforts for prostate cancer. As patients have presented for definitive therapy with earlier, smaller tumors, the significance of PNI on prostate needle biopsy specimens has decreased. The presence of PNI on biopsy specimens does not preclude cure after definitive therapy or mandate wide excision of the ipsilateral neurovascular bundle at the time of surgery, and it should not deter the performance of radical prostatectomy in a patient who is otherwise a good surgical candidate.
Do a google search for prostate cancer perineural invasion and you can learn a deal more.
2nd Pathology report. any comments appreciated as first consult with a radiology oncologist next week. I paid $150 for this 2nd report from a site recommended on this forum. Thanks for that Terry
For an additional $350 they offer a more detailed assessment but I passed on that
2ND OPINION RECEIVED 11/15/2012 MICROSCOPIC DESCRIPTION
A) Left Base: Benign prostatic glands and stroma.
B) Left Mid: Prostatic adenocarcinoma, Gleason score
3+3=6, measuring 2mm (10% of the tissue).
C) Left Apex: Prostatic adenocarcinoma, Gleason score
3+3=6, measuring 7mm (40% of the tissue).
D) Left Base Lat: Benign prostatic glands and stroma.
E) Left Lat Mid: Prostatic adenocarcinoma, Gleason score
3+3=6, measuring 2.5mm (20% of the tissue).
F) Left Lat Apex: Prostatic adenocarcinoma, Gleason score
3+3=6, measuring 1mm (7% of the tissue).
G) Right Base: Prostatic adenocarcinoma, Gleason score
3+4=7, measuring 4mm (30% of the tissue).
H) Right Mid: Small focus of atypical glands.
I) Right Apex: Prostatic adenocarcinoma, Gleason score
3+4=7, measuring 5mm (40% of the tissue).
J) Right Lat Base: Prostatic adencarcinoma, Gleason score
3+3=6, measuring 3mm (30% of the tissue).
K) Right Lat Mid: Small focus of atypical glands.
L) Right Lat Apex: Prostatic adenocarcinoma, Gleason
score 3+3=6, measuring 1mm (5% of the tissue).
Comments: Perineural invasion is seen in these biopsies.
Eight of twelve tissue cores are involved with
adenocarcinoma.
PHOTOMICROGRAPH
Malignant
Report Date: 11/16/2012
All malignant