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Can you tell if there's extra-prostatic PNI if nerve-sparing RP?

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Prostate Cancer
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Posted 9/1/2014 3:38 PM (GMT 0)
Hi all,

DH's post-op pathology report states that perineural invasion (PNI) is present intraprostatically. I think I understand that. And from what I've read, having PNI intraprostatically does NOT itself present a greater risk for or predict recurrence. (Not sure I worded that correctly but I think you get what I mean.)

Here's a silly question: if the surgery was nerve-sparing, is it possible to know whether or not PNI was also present extra-prostatically?

Thanks,
Melaine
Posted 9/1/2014 5:17 PM (GMT 0)
The surgeon sometimes has a pathologist standing by during the surgery and takes frozen sections for him to look at if there is any doubt in his mind that there is cancer near the neurovascular bundles. He won't spare the nerves, or at least not all of them, if the pathologist finds cancer there. You can ask your surgeon if he did this.

- Allen
Posted 9/1/2014 5:20 PM (GMT 0)
Hi Allen,

I'm going to send you an email about this. Hope that's okay.

Melaine
Posted 9/1/2014 5:39 PM (GMT 0)
Hi Allen,

My pre-op notes indicate that the surgeon has a pathologist right there. Actual notes: "Good tissue recognition. If messy, will check tissue during the operation. Pathologist right there."

Thanks for the reminder and the suggestion. I think I will contact the doctor and ask about this.

I don't know much about the anatomy and where the nerve bundles are. Am I right in concluding that if you don't look at the nerves outside the prostate, then you cannot tell whether or not there is extra-prostatic perineural invasion?
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