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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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| Published in: | The American journal of surgery 2017-04, Vol.213 (4), p.748-753 |
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| container_title | The American journal of surgery |
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| creator | Aurello, Paolo Berardi, Giammauro Tierno, Simone Maria Rampioni Vinciguerra, Gian Luca Socciarelli, Fabio Laracca, Giovanni Guglielmo Giulitti, Diego Pilozzi, Emanuela Ramacciato, Giovanni |
| description | 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 |
| doi_str_mv | 10.1016/j.amjsurg.2016.05.022 |
| format | article |
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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</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2016.05.022</identifier><identifier>PMID: 27613269</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>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</subject><ispartof>The American journal of surgery, 2017-04, Vol.213 (4), p.748-753</ispartof><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Apr 1, 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-8a4970fa3a0861dd95c2b394c2dd99b280167ff0cd5573179ac03c9dfc252c763</citedby><cites>FETCH-LOGICAL-c473t-8a4970fa3a0861dd95c2b394c2dd99b280167ff0cd5573179ac03c9dfc252c763</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27613269$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aurello, Paolo</creatorcontrib><creatorcontrib>Berardi, Giammauro</creatorcontrib><creatorcontrib>Tierno, Simone Maria</creatorcontrib><creatorcontrib>Rampioni Vinciguerra, Gian Luca</creatorcontrib><creatorcontrib>Socciarelli, Fabio</creatorcontrib><creatorcontrib>Laracca, Giovanni Guglielmo</creatorcontrib><creatorcontrib>Giulitti, Diego</creatorcontrib><creatorcontrib>Pilozzi, Emanuela</creatorcontrib><creatorcontrib>Ramacciato, Giovanni</creatorcontrib><title>Influence of perineural invasion in predicting overall survival and disease-free survival in patients With locally advanced gastric cancer</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>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</description><subject>Age Factors</subject><subject>Aged</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Gastrectomy</subject><subject>Gastric cancer</subject><subject>Humans</subject><subject>Italy - epidemiology</subject><subject>Lymph nodes</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Metastasis</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Invasiveness</subject><subject>Oncologic outcomes</subject><subject>Overall survival</subject><subject>Pancreatic cancer</subject><subject>Patients</subject><subject>Perineum - pathology</subject><subject>Perineural invasion</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - therapy</subject><subject>Surgery</subject><subject>Survival</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNqNkc9u1DAQxi1ERbeFRwBZ4sIlwX_iOD4hVBVaqRKXIo6W154sjrL2YieR-go8NQ67gMSlPXlG85tvxvMh9JqSmhLavh9qsx_ynHY1K2lNRE0Ye4Y2tJOqol3Hn6MNIYRVqqXkHF3kPJSU0oa_QOdMtpSzVm3Qz9vQjzMECzj2-ADJB5iTGbEPi8k-hhLgQwLn7eTDDscFSnXEZfLil8KZ4LDzGUyGqk8A_ypro5k8hCnjb376jsdoS-sDNm4xZaDDO5On5C22a5peorPejBlend5L9PXT9f3VTXX35fPt1ce7yjaST1VnGiVJb7ghXUudU8KyLVeNZSVWW9aVc8i-J9YJITmVyljCrXK9ZYJZ2fJL9O6oe0jxxwx50nufLYyjCRDnrMvxOlVUGHsCKpRsaNOKgr79Dx3inEL5yCrYMC5a1RVKHCmbYs4Jen1Ifm_Sg6ZEr77qQZ981auvmghNfi_y5qQ-b_fg_nb9MbIAH44AlMstHpLO1q-2Op_ATtpF_8iIX0jouI0</recordid><startdate>201704</startdate><enddate>201704</enddate><creator>Aurello, Paolo</creator><creator>Berardi, Giammauro</creator><creator>Tierno, Simone Maria</creator><creator>Rampioni Vinciguerra, Gian Luca</creator><creator>Socciarelli, Fabio</creator><creator>Laracca, Giovanni Guglielmo</creator><creator>Giulitti, Diego</creator><creator>Pilozzi, Emanuela</creator><creator>Ramacciato, Giovanni</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201704</creationdate><title>Influence of perineural invasion in predicting overall survival and disease-free survival in patients With locally advanced gastric cancer</title><author>Aurello, Paolo ; Berardi, Giammauro ; Tierno, Simone Maria ; Rampioni Vinciguerra, Gian Luca ; Socciarelli, Fabio ; Laracca, Giovanni Guglielmo ; Giulitti, Diego ; Pilozzi, Emanuela ; Ramacciato, Giovanni</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-8a4970fa3a0861dd95c2b394c2dd99b280167ff0cd5573179ac03c9dfc252c763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Biopsy</topic><topic>Cancer</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Gastrectomy</topic><topic>Gastric cancer</topic><topic>Humans</topic><topic>Italy - 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Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aurello, Paolo</au><au>Berardi, Giammauro</au><au>Tierno, Simone Maria</au><au>Rampioni Vinciguerra, Gian Luca</au><au>Socciarelli, Fabio</au><au>Laracca, Giovanni Guglielmo</au><au>Giulitti, Diego</au><au>Pilozzi, Emanuela</au><au>Ramacciato, Giovanni</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of perineural invasion in predicting overall survival and disease-free survival in patients With locally advanced gastric cancer</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2017-04</date><risdate>2017</risdate><volume>213</volume><issue>4</issue><spage>748</spage><epage>753</epage><pages>748-753</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>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</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27613269</pmid><doi>10.1016/j.amjsurg.2016.05.022</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| 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 |
| title | Influence of perineural invasion in predicting overall survival and disease-free survival in patients With locally advanced gastric cancer |
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