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Perineural Invasion questions

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Posted 8/14/2017 4:09 PM (GMT 0)
Does the positive perineural invasion finding on a biopsy ever get reduced/changed on a second opinion?

Does perineural invasion with 3+3=6 preclude AS?

As you can see I am in hopes ( guardedly so............) of good news from Dr. Epstein's second look at my biopsy.
Posted 8/14/2017 5:53 PM (GMT 0)
I'm no expert but by your signature you are a 4+3 G7. I would think that that alone would rule out AS.

But if you are asking for someone else, I would think the percentages of cores for G6 would be more of a factor in deciding treatment than PNI.

But other's with much more knowledge will likely chime in soon.
Posted 8/14/2017 7:55 PM (GMT 0)
Not an expert either, but the significance of PNI is not clear cut:

/www.ncbi.nlm.nih.gov/pmc/articles/PMC1476100/

So, I'm with alephnull; focus on your Gleason score and amount of positive cores.
Posted 8/14/2017 8:05 PM (GMT 0)
PNI seems to be quite common in pathology reports.

Unfortunately, the hopes of four cores of G4+3, and a fifth of G3+4 being reduced to a G3+3 upon an Epstein 2nd opinion is quite unrealistic. I'm afraid you not gonna hit that forth 5, or even second jack.

My suggestion is for you to do some in-depth evaluations of radiation and surgical treatments.

Good luck!
Posted 8/14/2017 8:28 PM (GMT 0)
Thx for info.
Yeh I know the downgrade, if there is one would not be a 3+3.
Mostly just looking for info and was curious if the PNI diagnosis ever changed on the second look.
A purely academic question.

Thx
Posted 8/15/2017 1:53 AM (GMT 0)
My URO, when discussing my pathology kinda shrugged off PNI saying that almost every day report had PNI.
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