Cancer Invasion to Auerbach's Plexus is an Important Prognostic Factor in Patients with pT3-pT4 Colorectal Cancer

Fujita, Shin; Nakanisi, Yukihiro; Taniguchi, Hirokazu; Yamamoto, Seiichiro; Aoki, Takayuki; Moriya, Yoshihiro; Shimoda, Tadakazu

doi:10.1007/s10350-007-9072-8

Cited by 51 publications

(49 citation statements)

References 25 publications

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“…In contrast to our results, other studies previously confirmed NI as a prognostic factor in colon cancer (28). However, most of these studies have quite low sample size, limited to certain tumor stages and do not distinguish between rectal and colon cancer, which represent biologically different cancer entities (27)(28)(29)(30).…”

Section: Discussioncontrasting

confidence: 99%

“…A major difference from other definitions of NI in colon cancer is the inclusion of invasion of Auerbach's plexus to the possible manifestations of NI in our study. Interestingly, there is only 1 study in literature that defined perineural invasion in colon cancer as invasion only into the AuP with a prevalence of 24% (27). The invasion of peripheral nerves was neither mentioned nor examined in their study.…”

Section: Discussionmentioning

confidence: 99%

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The Severity of Neural Invasion Is Associated with Shortened Survival in Colon Cancer

Liebl

Demir

Rosenberg

et al. 2013

Clinical Cancer Research

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Purpose: Neural invasion (NI) is a histopathologic feature of colon cancer that receives little consideration. Therefore, we conducted a morphologic and functional characterization of NI in colon cancer.Experimental Design: NI was investigated in 673 patients with colon cancer. Localization and severity of NI was determined and related to patient's prognosis and survival. The neuro-affinity of colon cancer cells (HT29, HCT-116, SW620, and DLD-1) was compared with pancreatic cancer (T3M4 and SU86.86) and rectal cancer cells (CMT-93) in the in vitro three-dimensional (3D)-neural-migration assay and analyzed via live-cell imaging. Immunoreactivity of the neuroplasticity marker GAP-43, and the neurotrophic-chemoattractant factors Artemin and nerve growth factor (NGF), was quantified in colon cancer and pancreatic cancer nerves. Dorsal root ganglia of newborn rats were exposed to supernatants of colon cancer, rectal cancer, and pancreatic cancer cells and neurite density was determined.Results: NI was detected in 210 of 673 patients (31.2%). Although increasing NI severity scores were associated with a significantly poorer survival, presence of NI was not an independent prognostic factor in colon cancer. In the 3D migration assay, colon cancer and rectal cancer cells showed much less neuritetargeted migration when compared with pancreatic cancer cells. Supernatants of pancreatic cancer and rectal cancer cells induced a much higher neurite density than those of colon cancer cells. Accordingly, NGF, Artemin, and GAP-43 were much more pronounced in nerves in pancreatic cancer than in colon cancer.Conclusion: NI is not an independent prognostic factor in colon cancer. The lack of a considerable biologic affinity between colon cancer cells and neurons, the low expression profile of colonic nerves for chemoattractant molecules, and the absence of a major neuroplasticity in colon cancer may explain the low prevalence and impact of NI in colon cancer.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Severity of Neural Invasion Is Associated with Shortened Survival in Colon Cancer

Liebl

Demir

Rosenberg

et al. 2013

Clinical Cancer Research

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“…Three studies reported on both intra and extramural perineural invasion [13,14,42]. Fujita [13] defined perineural invasion as cancer invasion to the Auerbach plexus and reported perineural invasion to be a more important prognostic factor than venous and lymphatic invasion in patients with colorectal cancer.…”

Section: Colorectal Cancermentioning

confidence: 99%

“…Fujita [13] defined perineural invasion as cancer invasion to the Auerbach plexus and reported perineural invasion to be a more important prognostic factor than venous and lymphatic invasion in patients with colorectal cancer. Ueno et al, 2013 [14], defined intramural perineural invasion as cancer spread along the Auerbach plexus and extramural perineural invasion as the histological finding of tumour cells invading or spreading along nerve fascicles external to the muscularis propria.…”

Section: Colorectal Cancermentioning

confidence: 99%

The role of perineural invasion in predicting survival in patients with primary operable colorectal cancer: A systematic review

Wyk

Going

Horgan

et al. 2017

Critical Reviews in Oncology/Hematology

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. (2017) The role of perineural invasion in predicting survival in patients with primary operable colorectal cancer: a systematic review. Critical Reviews in Oncology/Hematology, 112, pp. 11-20. (doi:10.1016/j.critrevonc.2017 This is the author's final accepted version.There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.http://eprints.gla.ac.uk/139181/ Therefore, the aim of the present study was to systematically review the identification and associations of perineural invasion and survival in patients with primary operable colorectal cancer. From initial search results of 912 articles, 38 studies were selected. Using H&E stains; five studies including 1835 patients reported on survival stratified by perineural invasion in colon cancer with weighted average detection rates of 26%; eleven studies including 3837 patients reported on rectal cancer with weighted average detection rates of 25% and; sixteen studies including 9145 patients reported on survival stratified by perineural invasion in colorectal cancer with weighted average detection rates of 17%. Using special techniques (S100), six studies including 1458 patients reported on the identification of perineural invasion in colorectal cancer.In comparison to H&E staining alone, the use of immunohistochemistry with S100 increased the detection of perineural invasion to approximately 70%.However, those studies did not examine the relationship with outcomes, so further research is required to establish the clinical significance of perineural invasion detected by immunohistochemistry. In conclusion, perineural invasion deserves special attention for improved prognostic stratification in patients with colorectal cancer. Further work is required to standardise pathology assessment and reporting of perineural invasion, in particular its definition, use of special stains and routine inclusion in pathology practice. Reliable assessment is required for investigations into mechanisms of perineural invasion, its role tumour spread and prognostic value.

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“…7 The prognostic significance of PNI is widely advocated in malignancies of the head and neck and prostate, [8][9][10] but controversies exist in colorectal cancer. [11][12][13][14] In T1-2 early rectal cancer, PNI is one of the adverse pathologic features in selecting patients undergoing local excision. But whether it can be used as a criterion to select patients receiving chemoradiotherapy in T3N0 patients is still unknown to us.…”

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confidence: 99%

Perineural invasion in pT3N0 rectal cancer

Peng

Sheng

Huang

et al. 2010

Cancer

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BACKGROUND:The authors' purpose was to explore the incidence and prognostic significance of perineural invasion (PNI) in pT3N0 rectal cancer. METHODS: Pathologic materials from resected specimens of 173 patients with pT3N0 rectal cancer were retrospectively collected. PNI-positivity was categorized into 2 groups: surrounding the nerve sheath (SS-PNI) and invading through the nerve sheath (TS-PNI). The rate of PNI-positivity was compared with PNI as initially recorded in the original reports. Patients' outcome was studied in groups with different PNI status, and multivariate analysis was performed to determine its prognostic value. RESULTS: In this retrospective analysis, PNIpositivity was found in 24.3% of all cases, in which SS-PNI and TS-PNI were 11% and 13.3%, respectively, and was related to lymphovascular invasion. Only 7.5% of patients' specimens were reported as PNI-positive in the original reports. Detection of SS-PNI was likelier to be missed than TS-PNI. The rates of local recurrence, disease-free survival, and overall survival at 5 years were similar between the groups of SS-PNI and TS-PNI. The 5-year local recurrence rate was more than 2.5-fold higher in the PNI-positive group compared with the PNI-negative group (22.7% vs 7.9%, respectively; P ¼ .017). Multivariate analysis proved that PNI-positivity was the only independent risk factor for predicting 5-year local recurrence rate, whereas only sampled lymph nodes was related to 5-year disease-free survival and overall survival. CONCLUSIONS: PNI is a common pathologic feature in rectal cancer. The definition of PNI should include SS-PNI and TS-PNI. Rectal cancer patients who are PNI-positive are at higher risk of local recurrence and should be considered for more intensive treatment.

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Cancer Invasion to Auerbach's Plexus is an Important Prognostic Factor in Patients with pT3-pT4 Colorectal Cancer

Abstract: Perineural invasion defined as cancer invasion to Auerbach's plexus is an important prognostic factor for colorectal cancer.

Cited by 51 publications

References 25 publications

The Severity of Neural Invasion Is Associated with Shortened Survival in Colon Cancer

The Severity of Neural Invasion Is Associated with Shortened Survival in Colon Cancer

The role of perineural invasion in predicting survival in patients with primary operable colorectal cancer: A systematic review

Perineural invasion in pT3N0 rectal cancer

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