Post Op Perineural Invasion (PNI)

User

Posted 02 Apr 2025 at 23:28

I’ve recently had my post op follow up with the consultant and he confirmed that the Gleason score remained at 6, however the margins were positive and so indicated a potential risk of recurrence in the future. One thing that we didn’t discuss but he then noted in the letter to my GP was that “there was some perineural invasion (PNI)”. I just wondered how common this is in post op histology reports?

User

Posted 03 Apr 2025 at 06:55

PNI can be a mechanism for further spread of prostate cancer but there is little definitive agreement as to how much it increases the risk of spread. PNI is not an unusual finding post surgery with some research papers suggesting more than 80% of men are found to have PNI following a prostatectomy and a close examination of the prostate in the path lab. I would take comfort from the fact your Gleason score is 6 indicating a far less aggressive form of prostate cancer than a higher Gleason score would indicate. All the best for the future.

User

Posted 03 Apr 2025 at 09:04

I agree entirely with IDK2. My post op histology raised my Gleason 8 (3+5) to Gleason 9 (4+5) and confirmed extraprostatic extension T3a, which both considerably increase the risk of recurrence. I had PNI which apparently does not. I was lucky enough to have negative margins.

As you stated, your positive margins, unfortunately do increase the risk of recurrence.

Two years later my PSA is undetectable, I hope yours does the same.👍

User

Posted 03 Apr 2025 at 12:00

Thank you both for your replies. Sounds like it’s nothing extra to worry about!

First PSA test was undetectable and so long may that continue, I really hope that yours stays that way too.

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