Perineural invasion as a predictor of extraprostatic extension of prostate cancer: A systematic review and meta-analysis

Gabriele Cozzi, Bernardo Maria Rocco, Angelica Grasso, Marco Rosso, Davide Abed El Rahman, Isabella Oliva, Michele Talso, Beatrice Costa, Ardit Tafa, Carlotta Palumbo, Franco Gadda, Francesco Rocco

Research output: Contribution to journalArticlepeer-review


A systematic review of the literature was performed to assess the relationship between the presence of perineural invasion (PNI) at prostate biopsy and extraprostatic extension (EPE) of prostate cancer. In August 2012, Medline, Embase, Scopus and Web of Science databases were searched. A "free-text" protocol using the terms "perineural invasion prostate cancer" was applied. Studies published only as abstracts and reports from meetings were not included in this review. In total, 341 records were retrieved from Medline, 507 from Embase, 374 from Scopus and 65 from the Web of Science database. The records were reviewed to identify studies correlating the presence of PNI with that of EPE. A cumulative analysis was conducted using Review Manager software v. 5.1 (Cochrane Collaboration, Oxford, UK). In univariate analysis, PNI showed a statistically significant association with pT3 tumours (p <0.00001), which could be observed for both pT3a (p <0.0001) and pT3b (p <0.0001). In conclusion, the cumulative analysis shows a statistically significant higher incidence of EPE in patients who had PNI at needle biopsy. The main limitation of the analysis was that it was not possible to perform a multivariate analysis. Further attempts to build a nomogram for the prediction of EPE could include the presence of PNI at needle biopsy.

Original languageEnglish
Pages (from-to)443-448
Number of pages6
JournalScandinavian Journal of Urology
Issue number6
Publication statusPublished - Dec 2013


  • Extraprostatic extension
  • Perineural invasion
  • Positive surgical margins
  • Prostate cancer

ASJC Scopus subject areas

  • Nephrology
  • Urology


Dive into the research topics of 'Perineural invasion as a predictor of extraprostatic extension of prostate cancer: A systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this