Perineural invasion in transitional cell carcinoma and the effect on prognosis following radical cystectomy

Ajay K. Nangia, Badrinath R. Konety, Steven Wachtel, Rajiv Dhir, Michael J. Becich, Robert R. Bahnson

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Objectives. The relationship between perineural invasion and prognosis has been demonstrated to be poor in a number of malignancies. This has not been evaluated in the bladder. We performed a study to determine the occurrence of nodal metastases, extranodal metastases, and disease-free survival in patients with perineural invasion (PNI) and/or angiolymphatic invasion (ALI) in transitional cell carcinoma of the bladder (TCCB) from radical cystectomy specimens. Methods. A retrospective review of 27 patients treated with radical cystectomy for TCCB was conducted. Comparisons were performed between three groups: PNI with or without ALl (PNI ± ALI, 12 patients), ALl alone (8 patients), and a control group (no PNI or ALl) (7 patients). Results. The mean patient age was 70 years (range 49 to 83). The overall median follow-up period was 11 months (range 1 to 32). PNI ± ALl was predominantly found in Stage T3b disease (14 of 20 [70%] cases). The overall 1 -year disease-free survival was 48%, 67%, and 83% for the PNI ± ALl, ALI alone, and control groups, respectively. Nodal metastases (for all stages combined) were found in 6 of 12 (50%), 3 of 8 (38%), and 1 of 7 (14%) patients in the PNI ± ALl, ALI alone, and control groups, respectively. Similarly, extranodal metastatic disease was found in 5 of 12 (42%), 4 of 8 (50%), and 1 of 7 (14%) patients in the PNI ± ALI, ALI alone, and control groups, respectively. The percentage of deaths for the PNI ± ALI, ALI only, and control groups were 33%, 50%, and 14%, respectively. Conclusions. In TCCB, perineural invasion with or without angiolymphatic invasion and angiolymphatic invasion alone are associated with a higher incidence of nodal and extranodal metastases and death.

Original languageEnglish (US)
Pages (from-to)968-972
Number of pages5
JournalUrology
Volume49
Issue number6
DOIs
StatePublished - Jun 1 1997

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