Effect Of Perineural Invasion Research Articles

The Effect of Perineural Invasion on Biochemical Recurrence-free Survival Following Nerve-sparing Radical Prostatectomy

The Effect of Perineural Invasion on Biochemical Recurrence-free Survival Following Nerve-sparing Radical Prostatectomy

Perineural Invasion Predicts Local Recurrence and Poor Survival in Laryngeal Cancer.

(1) Background: Perineural invasion (PNI) in head and neck cancer is associated with a poor prognosis; however, the effect of PNI on the prognosis of laryngeal cancer remains under debate. This retrospective study aimed to investigate the effect of PNI in fresh or salvaged larynges on survival in patients who had undergone laryngectomy for squamous cell carcinoma. (2) Methods: This study enrolled 240 patients diagnosed with laryngeal cancer who had undergone open surgery at Seoul St. Mary's Hospital, Korea. The effects of PNI, other histopathologic factors, and treatment history on survival and recurrence patterns were assessed. (3) Results: PNI was observed in 30 of 240 patients (12.5%). PNI (HR: 3.05; 95% CI: 1.90-4.88; p = 0.01) was a significant predictor of poor 5-year disease-free survival. In fresh cases, preepiglottic invasion (HR: 2.37; 95% CI: 1.45-3.88; p = 0.01) and PNI (HR: 2.96; 95% CI: 1.62-2.96; p = 0.01) were negative prognostic factors for 5-year disease-free survival. In the salvage group, however, only PNI (HR: 2.74; 95% CI: 1.26-5.92; p = 0.01) was a significant predictor of disease-free survival. Further, PNI significantly influenced high local recurrence (HR: 5.02, 95% CI: 1.28-9.66; p = 0.02). (4) Conclusions: Independent of treatment history, PNI is a prognostic factor for poor survival and local recurrence in laryngeal cancer.

Correlation analysis of perineural invasion and prognosis in cervical squamous carcinoma

Objective To investigate the relationship between perineural invasion (PNI) and clinicopathological features as well as the prognosis of cervical squamous carcinoma. Methods The clinico-pathological data of 256 patients with cervical squamous carcinoma (ⅠB1-ⅡA2) treated with extensive resection and pelvic lymphadenectomy in Shanxi Provincial Cancer Hospital from January 2010 to December 2013 were retrospectively analyzed. PNI of tumor area in the pathological sections was observed by using microscope. The relationship between PNI and clinicopathological features was analyzed. The effect of PNI on postoperative 5-year survival was also analyzed. Results There were 22 (8.6%) cases of PNI among 256 patients with cervical squamous carcinoma. PNI-positive had a relation with tumor stage, depth of invasion, lymphovascular space invasion (LVSI), and lymph node metastasis (all P 1/2 might be an independent risk factor for PNI (OR = 7.30, 95% CI 0.91-58.74, P = 0.062). The 5-year total survival rate was 89.9% for 256 patients with cervical squamous carcinoma. And the 5-year total survival rate of PNI-positive patients was lower than that of PNI-negative patients (50.3% vs. 93.4%). Cox regression showed that PNI-positive was a risk factor for 5-year total survival (HR = 9.73, 95% CI 4.31-21.98, P < 0.01); after adjusting the relevant clinicopathological features, PNI-positive was still a risk factor of 5-year total survival (HR = 8.12, 95% CI 2.47-26.73, P = 0.001). Conclusions The occurrence of PNI in cervical squamous carcinoma of ⅠB1-ⅡA2 is associated with clinical stage, depth of invasion, LVSI and lymph node metastasis. PNI-positive may be a new risk factor for the prognosis of cervical squamous carcinoma. Key words: Cervical neoplasms; Carcinoma, squamous cells; Perineural invasion; Clinicopathological features; Prognosis

Perineural invasion as a prognostic risk factor in patients with early cervical cancer.

The aim of the present study was to investigate the influence of perineural invasion (PNI) on the prognosis of patients with early cervical cancer (stages IA2-IIA2). A retrospective analysis was conducted on 406 patients with early cervical cancer who underwent a radical hysterectomy and pelvic lymphadenectomy between January 2007 and December 2014 at the Affiliated Hospital of Jiangnan University (Wuxi, China). The clinicopathological data of the patients were obtained and follow-up assessments were performed. A statistical analysis of the association between PNI and each index was performed, and the effect of PNI and the clinicopathological parameters on the prognosis of the patients was evaluated. Among the 406 cases with early cervical cancer, 41 cases were lost, with a follow-up rate of 89.90%. Overall, 43 PNI-positive patients were observed, with an occurrence rate of 10.59%. PNI-positivity was associated with hypertension, lymph node metastasis, depth of cervical invasion, surgical margin and vascular invasion (P<0.05), but it was not associated with age, diabetes, clinical stage, histological type or tumor size (P>0.05). The overall survival (OS) and disease-free survival (DFS) times of PNI-positive patients were significantly lower compared with those of PNI-negative patients. A multivariate regression analysis revealed that age, tumor size, clinical stage and PNI were independent risk factors for OS and DFS times. PNI is a poor prognostic factor for patients with early cervical cancer.

Effect of perineural invasion in prognosis of 1 801 patients undergoing radical resection of gastric cancer

Effect of perineural invasion in prognosis of 1 801 patients undergoing radical resection of gastric cancer

Prognostic Value of Perineural Invasion in Gastric Cancer: A Systematic Review and Meta-Analysis

BackgroundThe prognostic role of perineural invasion in gastric cancer is controversial. Here, we present a systemic review and meta-analysis of the association between perineural invasion and survival in resectable gastric cancer patients.MethodsA comprehensive literature search for relevant reports published up to April 2013 was performed using PubMed, Embase, Web of Science and Wanfang Data. Studies that investigated the role of perineural invasion with a sample size greater than 100 were included and analyzed.ResultsA total of 30,590 gastric cancer patients who had undergone curative gastrectomy from twenty-four studies were included. The median rate of perineural invasion positive was 40.9% (6.8%–75.6%). Fourteen studies investigated overall survival unadjusted for other variables in 23,233 gastric cancer patients. The relative hazard estimates ranged from 0.568–7.901 with a combined random effects estimate of 2.261 (95% CI = 1.841–2.777, P = 0.000). The effect of perineural invasion on overall survival adjusted for other prognostic factors was reported in 17 studies incorporating 8,551 cases. The hazard estimates ranged from 0.420–8.110 with a pooled random effects estimates of 1.484 (95% CI = 1.237–1.781, P = 0.000). There was heterogeneity between the studies (Q = 49.22, I-squared = 67.5%, P = 0.000). Disease-free survival was investigated adjusted in four studies incorporating 9,083 cases and the pooled fixed hazard ratio estimate was 1.371(95% CI = 1.230–1.527, P = 0.000).ConclusionPerineural invasion is an independent prognostic factor affecting overall survival and disease-free survival of gastric cancer patients who had undergone the curative resection. This effect is independent of lymph node status, tumor size and the depth of invasion as well as a range of other biological variables on multivariate analysis. Large prospective studies are now needed to establish perineural invasion as an independent prognostic marker for gastric cancer.

Perineural Invasion in the pN0 Neck in OCSCC

Objective: Perineural invasion (PNI) has been defined as an intermediate risk factor in OCSCC; however, its effect in the pathologically N0 (pN0) neck remains unclear. The objective of this study is to understand 1) the effect of PNI in pN0 OCSCC patients on outcomes, and 2) the role of adjuvant radiation (XRT). Method: Retrospective analysis of 90 OCSCC patients treated surgically with pN0 necks after neck dissection at a tertiary care center from 1999-2008. Overall 22% (20/90) were PNI-positive and 40% (36/90) underwent adjuvant XRT. Of those with PNI, 70% (14/20) underwent adjuvant XRT. Primary outcomes were OS, DSS, DFI, and LRC. Results: There were no differences between the PNI-positive and PNI-negative groups for age, gender, smoking or alcohol status, T-class, margin control, or median follow-up. PNI-positive patients had significantly worse DSS, DFI, and LRC than PNI-negative patients ( P = .049, P = .046, and P = .026, respectively), but there was no difference in OS between the 2 groups ( P = .15). Multivariate analysis verified PNI to be associated with worse DFI and LRC ( P = .02 and P = .006, respectively). Amongst PNI-positive patients, those who received adjuvant XRT demonstrated significantly improved DFI and LRC (mean 6.5 years vs 1.7 years; P = .012 and mean 6.7 years vs 1.9 years; P = .047, respectively). There was no improvement in OS or DSS in those receiving adjuvant XRT. Conclusion: Perineural invasion portends a worse DSS, DFI, and LRC in this cohort of patients with pN0 OCSCC. Adjuvant radiation significantly lengthens the DFI and improves LRC. Thus, it should be strongly considered for patients with PNI-positive pN0 OCSCC.

Analysis of clinical characteristics and prognosis of perineural invasion in patients with gastric carcinoma

To investigate the association between perineural invasion(PNI) and clinicopathological factors and the effect of PNI on overall survival in patients with gastric carcinoma. A total of 178 patients with gastric carcinoma from January 2004 to May 2008 were analyzed retrospectively. Paraffin sections of surgical specimens from all the patients who underwent gastric resection were stained with laminin. PNI-positive was defined as infiltration of carcinoma cells into the perineurium or neural fascicles. The association of PNI with clinicopathologic features and prognosis of gastric carcinoma was studied. PNI was positive in 78 of 178 patients(43.8%). The proportions of T stage, lymph node metastasis and TNM stage were significantly higher in PNI-positive group than those in PNI-negative group(all P<0.01). The PNI positive rate was correlated with the depth of gastric mural invasion and clinical stage. The overall survival in PNI-positive group was significantly lower than that in PNI-negative group by univariate analysis(P<0.01). The mean survival of PNI-positive patients(28.6 months) was significantly shorter than that of PNI-negative patients (44.3 months, P<0.01), which was also influenced by pN stage, pT stage, and clinical stage(P<0.01). By multivariable Cox proportional hazards model of overall survival, the positivity of PNI appeared to be an independent prognostic factor (hazards ratio=2.257, 95% CI:1.268-4.019, P=0.006). PNI is associated with the degree of malignancy in gastric cancer. PNI can be a candidate of new prognostic factor.

Prediction of Perineural Invasion and Its Prognostic Value in Patients with Prostate Cancer

PurposeThe prognostic significance of perineural invasion by prostate cancer is debated. We investigated the association between perineural invasion and clinicopathological factors and the effect of perineural invasion on survival in patients with prostate cancer.Materials and MethodsA total of 361 patients with prostate cancer without any neoadjuvant therapies prior to surgery from 1999 to 2010 were analyzed retrospectively. Whole-mount sections of surgical specimens from all patients who underwent radical prostatectomy were evaluated. Positive perineural invasion was defined as infiltration of cancer cells in the perineurium or neural fascicles. The relationship of perineural invasion with clinicopathological features and prognosis of prostate cancer was studied. We also researched preoperative factors that were associated with perineural invasion.ResultsPerineural invasion in a prostatectomy specimen (PNIp) was positive in 188 of 361 patients (52.1%). In the multivariate analysis of the preoperative variables, PNIp was related to the primary Gleason grade (p=0.020), the number of positive cores (p=0.008), and the percentage of tumor cells in positive cores (p=0.021), but not to perineural invasion of a prostate biopsy. In the evaluation between PNIp and pathologic findings of the prostatectomy specimen, PNIp was related to the Gleason score (p=0.010), T-stage (p=0.015), and lymphovascular invasion (p=0.019). However, by multivariate analysis, the PNIp was not an independent prognostic factor of biochemical serum recurrence (p=0.364) or cancer-specific survival (p=0.726).ConclusionsPNIp was significantly related to biologically aggressive tumor patterns but was not a prognostic factor for biochemical serum PSA recurrence or cancer-specific survival in patients with prostate cancer.

The Effect of Perineural Invasion on Overall Survival in Patients with Gastric Carcinoma

AimsThe availability of different treatment options for gastric carcinoma has reopened the question of correct definition of high-risk categories, which may help in identifying patients with high risk for poor prognosis who would benefit more from adjuvant therapy after operation. Perineural invasion (PNI) seems to provide useful information for management. Therefore, we examined the effect of PNI on overall survival (OS) in patients with gastric carcinoma and the association between PNI and other clinical and pathological factors. Patients and MethodsA total of 1,632 patients with gastric carcinoma from 2000 to 2005 were analyzed retrospectively. Paraffin sections of surgical specimens from all patients who underwent gastric resection were stained with laminin. If carcinoma cells infiltrated into the perineurium or neural fascicles, PNI was assessed as positive. Survival analysis was done in 1,372 patients with T1–T4 tumors who underwent curative resection. ResultPNI was positive in 518 of the 1,632 patients (31.7%). The size of tumors, T stage, differentiation of tumor, and clinical stage were significantly related to PNI positivity. The proportion of large tumors was significantly higher in PNI-positive patients than in PNI-negative patients (P < 0.01). As the depth of gastric mural invasion or clinical stage increased, the positive rate of PNI also increased. The OS of the PNI-positive patients was significantly shorter than that of the PNI-negative patients in the univariate analysis (P < 0.01). At multivariate Cox proportional hazards model of OS analysis, the positivity of PNI appeared to be an independent prognostic factor for OS (hazards ratio [HR] = 3.23, 95%CI = 2.6–8.11, P < 0.01), which was also influenced by tumor differentiation, T stage, and clinical stage (P < 0.01). ConclusionOur results suggested that the incidence of PNI was high in gastric carcinoma and that it corresponded to the progression of disease. It could provide additional information for identifying patients who are at high risk for poor prognosis. PNI can be a candidate for a new kind of prognostic parameters.

The significance of perineural invasion as a prognostic factor in patients with gastric carcinoma.

Few studies have investigated the prognostic significance of perineural invasion (PNI) in gastric cancer. Therefore, we examined the association between PNI and clinicopathological factors and the effect of PNI on overall survival in patients with gastric carcinoma. Paraffin sections of surgical specimens from 354 patients who underwent gastric resection were stained with hematoxylin and eosin. PNI was assessed histologically as positive when cancer cells were seen in the perineurium or neural fascicles. Survival analysis was done in 219 patients with T(2,3,4) tumors who underwent potentially curative resection. Data were collected prospectively. PNI was positive in 211 of the 354 patients (59.6%). The ratio of undifferentiated tumors, tumors with vascular invasion, and lymph node metastasis was significantly higher in the PNI-positive patients than in the PNI-negative patients ( P < 0.0001 for all three associations). As the depth of mural invasion increased, so did PNI positivity ( P < 0.0001). The overall survival of the PNI-positive patients was significantly worse than that of the PNI-negative patients in the univariate analysis ( P = 0.0009). However, PNI had no independent prognostic significance in the multivariate Cox proportional hazards model analysis. When the patients were separated into subgroups, PNI had prognostic value in patients with T(3) tumors ( P = 0.036) and no lymph node metastasis ( P = 0.005) in the univariate analysis, but no prognostic significance in the multivariate analysis. Although the incidence of PNI is high in gastric carcinoma and increases with the progression of disease, it does not provide any additional information to the classical prognostic parameters.