Prognostic Impact of Perineural Invasion in Rectal Cancer After Neoadjuvant Chemoradiotherapy

Kim, Chang‐Hyun; Yeom, Seung-Seop; Lee, Soo Young; Kim, Hyeong Rok; Kim, Young Jin; Lee, Kyung Hwa; Lee, Jae Hyuk

doi:10.1007/s00268-018-4774-8

Cited by 34 publications

(34 citation statements)

References 55 publications

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“…Consistently with the results reported by others, 9 our data support only LVI as a predictor of DFS, whereas we did not find any association between yp N/PNI and DFS. Finally, the association between PNI and tumour budding with OS or DFS proposed by other authors 8,9,24 is not confirmed by our results. Low numbers may have eventually prevented from reaching any significant difference in survival between patients with and without the reported parameters.…”

Section: Discussioncontrasting

confidence: 99%

“…Indeed, the impact of node metastasis on rectal cancer prognosis is a matter of debate 25–32 . On one hand, the presence of metastatic lymph nodes is considered one of the most significant predictor of short DFS and OS in patients affected by rectal cancer without distant metastasis 24–27 . In this regard, LNR is reportedly also an independent prognostic factor in such a population, regardless of the total number of examined lymph nodes 29 .…”

Section: Discussionmentioning

confidence: 99%

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Retrospective survival analysis of stage II–III rectal cancer: tumour regression grade, grading and lymphovascular invasion are the only predictors

Morini

Annicchiarico

Romboli

et al. 2020

ANZ Journal of Surgery

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Background Tumour regression grade is gaining interest as a prognostic factor of patients undergoing neoadjuvant chemoradiotherapy and surgery for locally advanced rectal cancer. Methods A series of 68 consecutive patients with locally advanced rectal cancer treated by neoadjuvant chemoradiotherapy and surgery between 2010 and 2016 was retrospectively studied. The impact on disease‐free survival (DFS) and overall survival (OS) of several criteria was analysed. Univariate analysis was performed through Kaplan–Meier statistics. Multivariate analysis was performed through Cox regression model. Using criteria found to be related to long‐term outcomes, a predictive model of patient's OS was calculated. Results Poor tumour regression grade – TRG3 (P = 0.010), poor grading – G3 (P = 0.001) and lymphovascular invasion (LVI; P = 0.030) were associated with short OS at univariate analysis. OS was associated with TRG3 and G3 at multivariate analysis (P = 0.016 and P = 0.027, respectively). DFS was associated with LVI (P = 0.001), G3 tumours (P = 0.046) and TRG3 (P = 0.045) at univariate analysis. At multivariate analysis, only LVI was associated with DFS (P = 0.041). A score, pondering the impact of three parameters (2 points for TRG3, 2 for G3 and 1 for LVI), was created and resulted to predict patient OS (P = 0.008), ranging from 94.5 months (score = 0–1) to 32 months (score = 3–5). Conclusion TRG3 and G3 were associated with poor OS, and LVI was the most significant predictor of DFS. An easy‐to‐use score may allow for a more accurate prediction of OS.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Retrospective survival analysis of stage II–III rectal cancer: tumour regression grade, grading and lymphovascular invasion are the only predictors

Morini

Annicchiarico

Romboli

et al. 2020

ANZ Journal of Surgery

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“…Some researchers attributed PNI pathogenesis to the close anatomical relationship between the tumour and neural plexus 16. However, the incidence of PNI was not high in rectal cancer patients despite the proximity to the presacral autonomic nerve plexus 27 28. Xia et al found that GC cells not only could promote the proliferation of neural progenitor cells but also enhance neurite elongation and branching of postmitotic neural cells in cancer-neural cell coculture condition in vitro 29.…”

Section: Discussionmentioning

confidence: 99%

Perineural invasion as a predictive factor for survival outcome in gastric cancer patients: a systematic review and meta-analysis

Zhao

Mei

et al. 2020

J Clin Pathol

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AimsThe prognostic significance of perineural invasion (PNI) for gastric cancer (GC) patients was under debate. This study aimed to review relevant studies and evaluate the impact of PNI on the survival outcome of GC patients.MethodsSystematic literature search was performed using PubMed and Embase databases. The relevant data were extracted, and the association between PNI and clinicopathological characteristics or survival outcome in GC patients were evaluated using a fixed-effect model or random-effect model.ResultsA total 13 studies involving 7004 GC patients were included in this meta-analysis. The positive rate of PNI was 35.9% (2512/7004) in GC patients, ranging from 6.9% to 75.6%. There were significant relationships between PNI and a series of unfavourable clinicopathological factors including undifferentiated histology type (OR: 1.78, 95% CI 1.37 to 2.33, p<0.001; I2=75.3%), diffuse type (OR: 1.96, 95% CI 1.07 to 3.60, p=0.029; I2=79.5%), lymphatic invasion (OR: 7.00, 95% CI 3.76 to 13.03, p<0.001; I2=83.6%), vascular invasion (OR: 5.79, 95% CI 1.59 to 21.13, p=0.008; I2=95.8%), deeper tumour invasion (OR: 4.79, 95% CI 3.65 to 6.28, p<0.001; I2=65.0%) and lymph node metastasis (OR: 3.60, 95% CI 2.37 to 5.47, p<0.001; I2=89.6%). In addition, PNI was significantly associated with worse survival outcome in GC patients (HR: 1.69, 95% CI 1.38 to 2.06, p<0.001; I2=71.0%).ConclusionPNI was frequently detected in surgically resected specimens of GC patients, and it was a predictive factor for survival outcomes in these patients.

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“…Even if NAT could be used to treat specific stages of GC, not all patients would benefit from NAT as expected. Recently, nomograms have been used for tumor prognosis prediction models after NAT [11][12][13][14][15][16]. These models show superior performance compared to conventional staging models [17][18][19][20][21].…”

Section: Ivyspringmentioning

confidence: 99%

Indications of neoadjuvant chemotherapy for locally advanced Gastric Cancer patients based on pre-treatment clinicalpathological and laboratory parameters

Wang¹,

Zhang²,

Guo³

et al. 2020

J. Cancer

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Objective: There are controversial indications for neoadjuvant chemotherapy (NAT) in the treatment of locally advanced gastric cancer (LAGC). Here, we aimed to identify indications for NAT based on pre-treatment clinicopathological and laboratory parameters. Methods: This study included a retrospective cohort of 1083 LAGC patients who had underwent radical D2 gastrectomy in the Cancer Hospital of China Medical University between 2012 and 2016. After propensity score matching, 756 patients were recruited and were separated into NAT (n=378) or primary surgery (PS) (n=378) groups. Cox regression identified pre-treatment risk factors for overall survival (OS). A nomogram was established to predict OS and calculate scores for risk factors. Recursive partitioning analysis (RPA) determined cut off values, where the entire patient cohort was divided into low and high risk groups. Results: Seven risk factors that were significantly related to OS were incorporated in the nomogram. These risk factors included age, tumor size, tumor site, carbohydrate antigen 199 (CA199), carcino-embryonic antigen (CEA), clinical T stage (cT) and clinical N stage (cN). The model contained a C-index of 0.637. The calibration curve revealed anticipated values that were reflective of actual values. The decision curve revealed an achievement of optimal clinical impact when threshold possibility was 0-54%. Next, the cohort was split into low (≤ 252 points) or high (> 252 points) risk groups based on the 5-year OS projected by RPA. The PS group showed a worse OS compared to the NAT group for high-risk patients (P =0.004). There was no significant difference when comparing OS between the PS and NAT groups for low-risk patients (P =0.407). Conclusions: A feasible, quantifiable and practical prognostic tool was generated to screen for potential survival benefits for patients receiving NAT. Surgeons can use this model to identify optimal treatment regimens for individualized treatment strategies during the diagnosis of LAGC patients. For these patients, NAT is suggested for high-risk patients.

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Prognostic Impact of Perineural Invasion in Rectal Cancer After Neoadjuvant Chemoradiotherapy

Cited by 34 publications

References 55 publications

Retrospective survival analysis of stage II–III rectal cancer: tumour regression grade, grading and lymphovascular invasion are the only predictors

Retrospective survival analysis of stage II–III rectal cancer: tumour regression grade, grading and lymphovascular invasion are the only predictors

Perineural invasion as a predictive factor for survival outcome in gastric cancer patients: a systematic review and meta-analysis

Indications of neoadjuvant chemotherapy for locally advanced Gastric Cancer patients based on pre-treatment clinicalpathological and laboratory parameters

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