Perineural invasion is a prognostic concern only on biopsy. The fact that his postop pathology was prostate contained, eliminates its prognostic value. Having said that there are some folks here and in the medical community who would argue that point and say postop pathology that shows PNI is still a prognostic concern.. Their argument goes something like this. It must be, because how do you explain
a recuurence for prostate contained surgery. This ties in with your other question…88% cure rate vs 12% recurrence rate. The reality is they do not know why some folks with prostate contained cancer have a recurrence. to willy nilly say well it has to be the pni is hardly scientific. It may well be that PNI has prognostic value, but it also could be from biopsy, a negative margin that wasn't negative{poor pathology technique}, or other surgical errors. To my knowledge no study or trial has ever been done to answer this question. It seems to me this would not be difficult to do, I suppose I conclude the fact that it hasn't been done, means the medical community is not concerned with the issue. By saying this this I admit to using the same illogical thinking, others use in saying pni must be the reason, so take it with the same grain of salt as you should with Postop pni having prognostic value with a fully contain pros tate. I will go out on a limb and say that there is a lot more PNI in post op pathology then there are recurrences in a prostectemy patients[as well as other type treatments}. the 88/12% numbers you refer to statistical studies{someone correct me, if the that phrase lacks merit}. The reality is that many prostate contained specimens recure. With your husbands pathology as you reported….excellent, IMO, it is highly likely your husband is cured. Do not quiver over ever arrow of doubt that enters your mind. LIfe is too short for any of us to waste it on that kine stuff. Oh, incontinence is a routine side/effect of a prostectemy . look back at recent threads on the subject, the forum is inundated with them{pun intended.} You both have a very promising future ,free of PCA. Regards. PS pick up Patrick Walshes book on PCA, read it and if necessary study it. It will soothe you both on many of those arrows. Knowledge and Faith have a powerful alchemical effect… in a an extremely counterintuitive fashion. The future will ironically consider it intuitive. Its a strange existence…wonderful actually.
