Influence of perineural invasion in predicting overall survival and disease-free survival in patients With locally advanced gastric cancer

The aim of the present study was to evaluate the prognostic significance of perineural invasion (PNI) in locally advanced gastric cancer patients who underwent D2 gastrectomy and adjuvant chemotherapy. The records of a series of 103 patients undergoing D2 gastrectomy with curative intent combined wi...

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Bibliographic Details
Published in:The American journal of surgery 2017-04, Vol.213 (4), p.748-753
Main Authors: Aurello, Paolo, Berardi, Giammauro, Tierno, Simone Maria, Rampioni Vinciguerra, Gian Luca, Socciarelli, Fabio, Laracca, Giovanni Guglielmo, Giulitti, Diego, Pilozzi, Emanuela, Ramacciato, Giovanni
Format: Article
Language:English
Subjects:
Age Factors
Aged
Biopsy
Cancer
Chemotherapy
Chemotherapy, Adjuvant
Disease-Free Survival
Female
Gastrectomy
Gastric cancer
Humans
Italy - epidemiology
Lymph nodes
Lymphatic Metastasis
Lymphatic system
Male
Medical prognosis
Metastasis
Multivariate Analysis
Neoplasm Invasiveness
Oncologic outcomes
Overall survival
Pancreatic cancer
Patients
Perineum - pathology
Perineural invasion
Prognosis
Retrospective Studies
Stomach Neoplasms - mortality
Stomach Neoplasms - pathology
Stomach Neoplasms - therapy
Surgery
Survival
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Summary:The aim of the present study was to evaluate the prognostic significance of perineural invasion (PNI) in locally advanced gastric cancer patients who underwent D2 gastrectomy and adjuvant chemotherapy. The records of a series of 103 patients undergoing D2 gastrectomy with curative intent combined with adjuvant chemotherapy from January 2004 to December 2014 were retrospectively reviewed. PNI was positive in 47 (45.6%) specimens. The 1-, 3-, and 5-year overall survival rates were 81%, 55%, and 42%, respectively. The 1-, 3-, and 5-year disease-free survival (DFS) rates were 76%, 57%, and 49%, respectively. A multivariate analysis showed that age number of positive lymph nodes, T stage, and PNI were independently associated with overall survival. Regarding DFS, the multivariate analysis showed that only PNI was independently associated with DFS. PNI and T stage and positive lymph nodes are independent markers of poor prognosis in patients with gastric cancer. PNI should be incorporated in the postoperative staging system for planning follow-up after surgery and in our opinion to propose more aggressive postoperative therapies in PNI-positive patients. •Perineural invasion (PNI) is an important pathologic feature of neoplasms.•Influence of PNI is used for staging in different types of tumors.•Prognosis of gastric cancer patients is shown to be influenced by PNI.•PNI should be considered to plan the best systemic treatment after surgery
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2016.05.022