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. 2023 Apr;12(8):9401-9408.
doi: 10.1002/cam4.5701. Epub 2023 Mar 23.

Lymphovascular or perineural invasion is associated with lymph node metastasis and survival outcomes in patients with gastric cancer

Fengxiang Zhang  1 , Huaxian Chen  1   2 , Dandong Luo  1   2 , Zhizhong Xiong  1   2 , Xianzhe Li  1   2 , Shi Yin  1   2 , Longyang Jin  1 , Shi Chen  1 , Junsheng Peng  1 , Lei Lian  1   2
Affiliations

Lymphovascular or perineural invasion is associated with lymph node metastasis and survival outcomes in patients with gastric cancer

Fengxiang Zhang et al. Cancer Med. 2023 Apr.

Abstract

Background: Lymphovascular invasion (LVI) and perineural invasion (PNI) are associated with poorer prognosis in several human malignancies, but their significance in gastric cancer (GC) remains to be clearly defined. Our study aimed to investigate the prognostic value of LVI/PNI in patients with curative resected GC.

Methods: Records of 1488 patients with stage I--III GC and 3327 patients with stage I-III colorectal cancer (CRC) were reviewed retrospectively, and difference in the incidence of LVI/PNI between GC and CRC was compared. Univariate and multivariate analyses were used to evaluate whether LVI/PNI was an independent risk factor for lymph node metastasis (LNM) and overall survival (OS) in GC.

Results: Patients with stage I-III GC had a significantly higher incidence of LVI/PNI than patients with stage I-III CRC (50.54% vs. 21.91%, p < 0.001). LVI/PNI was significantly associated with higher CEA, higher CA199, deeper tumor invasion, more lymph node metastasis, and advanced TNM stage in GC ( p < 0.05). Multivariate logistic regression analysis identified LVI/PNI (OR = 2.64, 95%CI: 2.05-3.40, p < 0.001) as an independent risk factor for LNM in GC. The OS rate was significantly lower in the LVI/PNI-positive GC group than that in the LVI/PNI-negative GC group ( p < 0.001). On multivariate Cox regression analysis, LVI/PNI (HR = 1.34, 95%CI: 1.04-1.71, p = 0.023) was an independent prognostic factor for OS in GC.

Conclusion: GC has a high incidence of LVI/PNI, which was closely associated with disease progression. LVI/PNI could serve as an independent risk factor for LNM and the prognosis of patients with curative resected GC. These findings will be helpful in predicting survival outcomes more accurately and establishing individualized treatment plans.

Keywords: gastric cancer; lymph node metastasis; lymphovascular invasion; perineural invasion; prognosis.

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Conflict of interest statement

The authors have no conflict of interest regarding the content of the article.

Figures

FIGURE 1
FIGURE 1
Flowchart of the study.
FIGURE 2
FIGURE 2
The incidence of LVI/PNI in gastric cancer (GC) and colorectal cancer. (A) Difference in the incidence of LVI/PNI between GC and colorectal cancer. (B) The incidence of LVI/PNI was increasing with advanced T stage or N stage in GC.
FIGURE 3
FIGURE 3
Kaplan–Meier analysis of overall survival based on LVI/PNI status among 1488 patients with stage I–III gastric cancer who underwent curative gastrectomy.
See this image and copyright information in PMC

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