Abstract
Background Several studies have been conducted to investigate the association between the presence of perineural invasion (PNI) and overall survival (OS) of gastric cancer (GC) patients who underwent curative resection, but no consensus has been reached. This study is aimed at determining the prognostic significance of PNI in gastric cancer. Study Design. The data of 2969 patients with gastric cancer and who had undergone curative gastrectomy from 2006 to 2010 in two high-volume hospitals of China and Korea were retrospectively analyzed. PNI positivity was identified when carcinoma cells were found to infiltrate into the perineurium or neural fascicles. The relationships between PNI and other clinicopathological factors were evaluated, and survival analyses were performed. Results The presence of PNI was detected in 1055 of the 2969 patients (35.5%). Nationality, age, tumor location, size of tumor, differentiation of the tumor, pT stage, pN stage, lymphatic invasion, and vascular invasion had been associated with PNI positivity. The mean survival time of patients with and without PNI was 62.5 months and 87.3 months, respectively (P < 0.001). However, the presence of PNI was not an independent prognostic factor for gastric cancer, except for patients in stage III (P = 0.037, hazard ratio: 1.21, 95% confidence interval: 1.01-1.44). Conclusion PNI occurs frequently in patients with gastric cancer, and the incidence of PNI increases with the staging of the tumor. The presence of PNI can provide additional information in predicting the survival outcome for those with stage III tumors.
Highlights
Gastric cancer (GC) has been a great threat to public health
There were more than 900,000 new cases diagnosed annually and more than 700,000 deaths caused by gastric cancer (GC) in a year, and the prognosis was not promising with the cumulative 5-year survival in most countries remaining in the narrow range of 2530% in recent years—except for Japan and Korea [2]
We investigated the relationships between perineural invasion (PNI) and other clinicopathological factors in GC and assessed the prognostic value of PNI in GC, aiming to provide additional effective prognostic predictors for GC
Summary
Gastric cancer (GC) has been a great threat to public health. the incidence of GC has been gradually decreasing during the past few decades, it is still the fifth most common cancer and the third most lethal cancer worldwide [1]. Despite the TNM staging system which has greatly helped the doctors to assess patients’ prognosis and choose the stage-specific therapeutic strategy, the survival rates of patients with the same stage might have great differences, which means that other prognostic factors could. Several studies have been conducted to investigate the association between the presence of perineural invasion (PNI) and overall survival (OS) of gastric cancer (GC) patients who underwent curative resection, but no consensus has been reached. The presence of PNI was not an independent prognostic factor for gastric cancer, except for patients in stage III (P = 0:037, hazard ratio: 1.21, 95% confidence interval: 1.01-1.44). PNI occurs frequently in patients with gastric cancer, and the incidence of PNI increases with the staging of the tumor. The presence of PNI can provide additional information in predicting the survival outcome for those with stage III tumors
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