Influencing factors for positive perineural invasion after laparoscopic radical prostatectomy

Abstract:

Objective To analyze the influencing factors for positive perineural invasion in pathological specimens after laparoscopic radical prostatectomy.Methods The clinical data of 104 patients who underwent laparoscopic radical prostatectomy in the Department of Urology of the Affiliated Hospital of North Sichuan Medical College from January 2018 to March 2023 were retrospectively analyzed. The patient’s age，smoking history，drinking history，preoperative total prostate-specific antigen（TPSA），ratio of preoperative free prostate-specific antigen/TPSA（F/T ratio），postoperative pathological Gleason score，capsular invasion，perineural invasion，resection margin，seminal vesicle invasion，and pathological T stage were collected. According to the postoperative pathological results，the patients were divided into two groups： positive perineural invasion group and negative perineural invasion group. The age，smoking history，drinking history，preoperative TPSA，preoperative F/T ratio，postoperative pathological Gleason score，capsular invasion，resection margin，seminal vesicle invasion，and pathological T stage were compared between the two groups. The chi-square test and multivariate logistic regression analysis were used to analyze the variables to explore the influencing factors for positive perineural invasion.Results A total of 104 patients were included in this study，including 30 patients with positive perineural invasion（28.85%） and 74 patients with negative perineural invasion（71.15%）. All patients were confirmed to have prostate cancer by postoperative pathological results. Univariate analysis showed that there were significant differences in age，F/T ratio，Gleason score，capsular invasion，positive resection margin，seminal vesicle invasion，and pathological T stage（P<0.05），and that there were no significant differences in smoking history，drinking history，and preoperative TPSA（P>0.05）. The statistically significant indices were included in multivariate logistic regression analysis，and the results showed that age <70 years and positive resection margin were independent influencing factors for positive perineural invasion after laparoscopic radical prostatectomy（P<0.05）.Conclusion Age，F/T ratio，Gleason score，capsular invasion，positive resection margin，seminal vesicle invasion，and pathological T stage are significantly related to positive perineural invasion after laparoscopic radical prostatectomy. Among them，age <70 years and positive resection margin are independent risk factors for positive perineural invasion after laparoscopic radical prostatectomy.