Extramural Perineural Invasion in pT3 and pT4 Gastric Carcinomas
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Perineural invasion (PNI) is widely studied in malignant tumors, and its prognostic significance is well demonstrated. Most studies have focused on evaluating the mural PNI (mPNI); however, extramural PNI (ePNI) may influence the prognosis in gastric cancer. We evaluated the prognostic value of ePNI compared with mPNI in gastric cancer in this observational comparative cross-sectional study. Methods: Seventy-three pT3 and pT4 gastric carcinomas with PNI were evaluated. Forty-eight (65.7%) were in the mPNI group and the remaining in the ePNI group. Results: Clinicopathologic characteristics between the two groups were similar, except for the outcomes. The 5-year disease-specific survival (DSS) rate was 64% for the mPNI group and 50% for the ePNI group (p = .039), a difference that did not remain significant in multivariate analysis. The only independent adverse prognostic factor in multivariate analysis was the presence of lymph node metastasis (hazard ratio, 1.757; 95% confidence interval, 1.082 to 2.854; p = .023). Conclusions: We demonstrated the prognostic effect of ePNI for DSS in surgically resected pT3–pT4 gastric cancer patients. ePNI could be considered in the staging and prognostic systems of gastric cancer to stratify patients with a high risk of recurrence.
Abstract
Background: Perineural invasion (PNI) is widely studied in malignant tumors, and its prognostic significance is well demonstrated. Most studies have focused on evaluating the mural PNI (mPNI); however, extramural PNI (ePNI) may influence the prognosis in gastric cancer. We evaluated the prognostic value of ePNI compared with mPNI in gastric cancer in this observational comparative cross-sectional study. Methods: Seventy-three pT3 and pT4 gastric carcinomas with PNI were evaluated. Forty-eight (65.7%) were in the mPNI group and the remaining in the ePNI group. Results: Clinicopathologic characteristics between the two groups were similar, except for the outcomes. The 5-year disease-specific survival (DSS) rate was 64% for the mPNI group and 50% for the ePNI group (p = .039), a difference that did not remain significant in multivariate analysis. The only independent adverse prognostic factor in multivariate analysis was the presence of lymph node metastasis (hazard ratio, 1.757; 95% confidence interval, 1.082 to 2.854; p = .023). Conclusions: We demonstrated the prognostic effect of ePNI for DSS in surgically resected pT3–pT4 gastric cancer patients. ePNI could be considered in the staging and prognostic systems of gastric cancer to stratify patients with a high risk of recurrence.
참고문헌 (21)
- [URL]
- Fagan JJ, "Perineural invasion in squamous cell carcinoma of the head and neck", Arch Otolaryngol Head Neck Surg, 124, pp.637~640 (1998)[DOI]
- Liebig C, "Perineural invasion in cancer: a review of the literature", Cancer, 115, pp.3379~3391 (2009)[DOI]
- Batsakis JG, "Nerves and neurotropic carcinomas", Ann Otol Rhinol Laryngol, 94(4), pp.426~427 (1985)
- Liebig C, "Perineural invasion is an independent predictor of outcome in colorectal cancer", J Clin Oncol, 27, pp.5131~5137 (2009)[DOI]
- Hassan MO, "The prostatic perineural space and its relation to tumor spread: an ultrastructural study", Am J Surg Pathol, 4, pp.143~148 (1980)[DOI]
- Reina MA, "Morphology of peripheral nerves, their sheaths, and their vascularization", Rev Esp Anestesiol Reanim, 47, pp.464~475 (2000)
- Ayala GE, "In vitro dorsal root ganglia and human prostate cell line interaction: redefining perineural invasion in prostate cancer", Prosate, 49, pp.213~223 (2001)[DOI]
- Boyd JG, "Neurotrophic factors and their receptors in axonal regeneration and functional recovery after peripheral nerve injury", Mol Neurobiol, 27, pp.277~324 (2003)[DOI]
- Ketterer K, "Reverse transcription-PCR analysis of laser-captured cells points to potential paracrine and autocrine actions of neurotrophins in pancreatic cancer", Clin Cancer Res, 9, pp.5127~5136 (2003)
- Okada Y, "Nerve growth factor stimulates MMP-2 expression and activity and increases invasion by human pancreatic cancer cells", Clin Exp Metastasis, 21, pp.285~292 (2004)[DOI]
- Deng J, "Prognostic value of perineural invasion in gastric cancer: a systematic review and meta-analysis", PLoS One, 9, pp.e88907~ (2014)[DOI]
- Ueno H, "Criteria for extramural perineural invasion as a prognostic factor in rectal cancer", Br J Surg, 88, pp.994~1000 (2001)[DOI]
- Edge SB, "American Joint Committee on Cancer Cancer staging manual" (2010), Springer
- Ceyhan GO, "The severity of neural invasion is a crucial prognostic factor in rectal cancer independent of neoadjuvant radiochemotherapy", Ann Surg, 252, pp.797~804 (2010)[DOI]
- Tanaka A. Watabe T, "Perineural invasion as a predictor of recurrence of gastric cancer", Cancer, 73, pp.550~555 (1994)[DOI]
- Duraker N, "The significance of perineural invasion as a prognostic factor in patients with gastric carcinoma", Surg Today, 33, pp.95~100 (2003)[DOI]
- Bilici A, "Prognostic significance of perineural invasion in patients with gastric cancer who underwent curative resection", Ann Surg Oncol, 17, pp.2037~2044 (2010)[DOI]
- Tianhang L, "The effect of perineural invasion on overall survival in patients with gastric carcinoma", J Gastrointest Surg, 12, pp.1263~1267 (2008)[DOI]
- Selcukbiricik F, "Perineural invasion independent prognostic factors in patients with gastric cancer undergoing curative resection", Asian Pac J Cancer Prev, 13, pp.3149~3152 (2012)[DOI]
- Jiang N, "Incorporation of perineural invasion of gastric carcinoma into the 7th edition tumornode- metastasis staging system", Tumour Biol, 35, pp.9429~9436 (2014)[DOI]