What does this research mean for the field?

Baseline factors including biopsy PSA, preoperative PSA, biopsy Grade Group, prostate volume, and family history of cancer are correlated with perineural invasion in prostate cancer patients, with a family history of prostate cancer specifically decreasing the risk. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To identify baseline factors that predict perineural invasion in prostate cancer patients undergoing radical prostatectomy.

May 31, 2026Open Access

Baseline Predictors of Perineural Invasion and Their Relationship With Adverse Histopathological Findings in Radical Prostatectomy Specimens in Prostate Cancer Patients

Key Points

To identify baseline factors that predict perineural invasion in prostate cancer patients undergoing radical prostatectomy.
Conducted a retrospective analysis on 921 prostate cancer patients who underwent radical prostatectomy from 2012 to 2022.
Categorized patients into perineural invasion positive (PNI+) and negative (PNI−) groups based on histopathological analysis.
Analyzed demographic and clinicopathological variables for correlation with perineural invasion status.
Family history of prostate cancer and other cancers correlated with perineural invasion (p = 0.001).
Average prostate-specific antigen levels and biopsy Grade Group significantly correlated with perineural invasion (mean biopsy PSA p < 0.001, mean preoperative PSA p < 0.001, biopsy GG p = 0.043).
Logistic regression showed family history of prostate cancer decreases the risk of perineural invasion (OR = 0.373).

Abstract

Introduction Perineural invasion (PNI) is an independent prognostic factor in prostate cancer (PCa) patients following radical prostatectomy (RP), although findings across studies remain inconsistent. We aimed to identify the baseline factors associated with the occurrence of PNI in RP specimens. Methods A retrospective analysis was conducted on 921 PCa patients who underwent RP at our institution between 2012 and 2022. Baseline predictors and histopathological PNI status were analyzed. Patients were categorized into PNI+ ( n = 838) and PNI− ( n = 83) groups. Results Among demographic variables, family history of both PCa ( p = 0.001) and other cancers ( p = 0.001) was correlated with PNI. Several clinicopathological variables, including average prostate‐specific antigen (PSA) at diagnosis—mean biopsy PSA ( p < 0.001), mean preoperative PSA ( p < 0.001), prostate volume (PV) ( p = 0.034), and biopsy Grade Group (GG) ( p = 0.043), showed correlation with PNI. Conversely, none of the other serum parameters, including preoperative testosterone, albumin, platelets, neutrophils, lymphocytes, and hemoglobin, exhibited correlation with PNI. Logistic regression analysis showed that a family PCa history decreases the risk of PNI (odds ratio OR = 0.373). Conclusions We found a correlation of PNI with recognized prognostic factors (biopsy PSA, preoperative PSA, and biopsy GG) but also with other variables (PV, family history of PCa, and family history of other cancers).

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