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. 2015 Oct 27:8:3153-7.
doi: 10.2147/OTT.S90909. eCollection 2015.

Perineural invasion correlates with postoperative distant metastasis and poor overall survival in patients with PT1-3N0M0 esophageal squamous cell carcinoma

Liming Sheng  1 , Yongling Ji  1 , Xianghui Du  1
Affiliations

Perineural invasion correlates with postoperative distant metastasis and poor overall survival in patients with PT1-3N0M0 esophageal squamous cell carcinoma

Liming Sheng et al. Onco Targets Ther. .

Abstract

The aim of this study was to determine the prognostic value of perineural invasion (PNI) in patients with PT1-3N0M0 esophageal squamous cell carcinoma (ESCC) who underwent curative resection. A total of 148 patients with PT1-3N0M0 ESCC, who underwent surgery in Zhejiang Cancer Hospital (Hangzhou, People's Republic of China), between 2006 and 2009, were evaluated in this retrospective study. The effects of PNI on distant metastasis-free survival (DMFS) and overall survival (OS) were assessed using Kaplan-Meier analysis. Independent prognostic factors were identified by multivariate Cox analysis. Positive PNI was identified in 25.0% of all the cases. The depth of invasion (PT stage) was closely associated with the PNI positivity (P<0.001). The 5-year DMFS rate and OS rate of the PNI-positive patients were significantly worse than those of the PNI-negative patients (DMFS: 37.2% vs 62.3%, P=0.009; OS: 31.3% vs 74.3%, P,0.001). Multivariate analysis indicated that the positivity of PNI was an independent prognostic factor for both DMFS (hazard ratio [HR] =2.35, P=0.039) and OS (HR =3.56, P=0.002). Our results suggest that PNI was a predictor of distant metastasis and independently associated with prognosis of patients with PT1-3N0M0 ESCC.

Keywords: esophageal squamous cell carcinoma; metastasis; perineural invasion; prognosis.

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Figures

Figure 1
Figure 1
DMFS curve subdivided by PNI in PT1–3N0 ESCC. Note: Patients with PNI-positive tumors showed significantly poorer DMFS than those with PNI-negative tumors (P=0.009, log-rank test). Abbreviations: DMFS, distant metastasis-free survival; PNI, perineural invasion; ESCC, esophageal squamous cell carcinoma.
Figure 2
Figure 2
OS curve subdivided by PNI in PT1–3N0 ESCC. Note: Patients with PNI-positive tumors showed significantly poorer OS than those with PNI-negative tumors (P<0.001, log-rank test). Abbreviations: PNI, perineural invasion; OS, overall survival; ESCC, esophageal squamous cell carcinoma.
See this image and copyright information in PMC

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