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. 2018 Mar;52(2):79-84.
doi: 10.4132/jptm.2017.11.01. Epub 2017 Nov 9.

Extramural Perineural Invasion in pT3 and pT4 Gastric Carcinomas

Alejandro España-Ferrufino  1 , Leonardo S Lino-Silva  1 , Rosa A Salcedo-Hernández  2
Affiliations

Extramural Perineural Invasion in pT3 and pT4 Gastric Carcinomas

Alejandro España-Ferrufino et al. J Pathol Transl Med. 2018 Mar.

Abstract

Background: Perineural invasion (PNI) is widely studied in malignant tumors, and its prognostic significance is well demonstrated. Most studies have focused on evaluating the mural PNI (mPNI); however, extramural PNI (ePNI) may influence the prognosis in gastric cancer. We evaluated the prognostic value of ePNI compared with mPNI in gastric cancer in this observational comparative cross-sectional study.

Methods: Seventy-three pT3 and pT4 gastric carcinomas with PNI were evaluated. Forty-eight (65.7%) were in the mPNI group and the remaining in the ePNI group.

Results: Clinicopathologic characteristics between the two groups were similar, except for the outcomes. The 5-year disease-specific survival (DSS) rate was 64% for the mPNI group and 50% for the ePNI group (p=.039), a difference that did not remain significant in multivariate analysis. The only independent adverse prognostic factor in multivariate analysis was the presence of lymph node metastasis (hazard ratio, 1.757; 95% confidence interval, 1.082 to 2.854; p=.023).

Conclusions: We demonstrated the prognostic effect of ePNI for DSS in surgically resected pT3-pT4 gastric cancer patients. ePNI could be considered in the staging and prognostic systems of gastric cancer to stratify patients with a high risk of recurrence.

Keywords: Neoplasms; Perineural invasion; Prognostic factor; Stomach neoplasms; Survival.

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Conflict of interest statement

Conflicts of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Histologic microphotography showing perineural space invasion. Note that neoplastic glands invade perineurium and encases at least 33% of the circumference of the nerve.
Fig. 2.
Fig. 2.
Five-year disease-specific survival of 73 patients with gastric carcinoma divided by perineural invasion.
See this image and copyright information in PMC

References

    1. Ferlay J, Soerjomataram I, Ervik M. Lyon: International Agency for Research on Cancer; 2013. GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC CancerBase No. 11. IARC CancerBase No. 11 [Internet] [cited 2017 Dec 10]. Available from: http://globocan.iarc.fr.
    1. Fagan JJ, Collins B, Barnes L, D’Amico F, Myers EN, Johnson JT. Perineural invasion in squamous cell carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg. 1998;124:637–40. - PubMed
    1. Liebig C, Ayala G, Wilks JA, Berger DH, Albo D. Perineural invasion in cancer: a review of the literature. Cancer. 2009;115:3379–91. - PubMed
    1. Batsakis JG. Nerves and neurotropic carcinomas. Ann Otol Rhinol Laryngol. 1985;94(4 Pt 1):426–7. - PubMed
    1. Liebig C, Ayala G, Wilks J, et al. Perineural invasion is an independent predictor of outcome in colorectal cancer. J Clin Oncol. 2009;27:5131–7. - PMC - PubMed

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