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Prognostic Significance of Perineural Invasion in Patients with Gastric Cancer Who Underwent Curative Resection

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The prognostic significance of perineural invasion (PNI) in gastric cancer has been previously investigated in a few studies, but had not reached a consensus. The aim of this study was to determine the prognostic value of PNI in patients with gastric cancer who underwent curative resection.

Materials and Methods

We retrospectively analyzed 238 patients who had undergone curative gastrectomy. Paraffin sections of surgical specimens from all patients were stained with hematoxylin and eosin. PNI was defined when carcinoma cells infiltrated into the perineurium or neural fascicles. PNI and the other prognostic factors were evaluated by univariate and multivariate analysis.

Results

PNI was detected as positive in 180 of the 238 patients (75.6%). pT stage, tumor size, lymph node metastasis, clinical stage, tumor differentiation, Borrmann classification, histological type, lymphatic vessel invasion, and blood vessel invasion were closely associated with the presence of PNI. The PNI-positive tumors had significantly larger size and more lymph node metastasis than the PNI-negative tumors (P = .001 and P < .001, respectively). The median survival of the PNI-positive patients was significantly worse than that of the PNI-negative patients (28.1 vs. 64.9 months, P = .001). Multivariate analysis indicated that the positivity of PNI was an independent prognostic factor (P = .02, hazard ratio [HR]: 2.75; 95% confidence interval [95% CI]:1.12–3.13) as were classical clinicopathological features.

Conclusion

Our results showed that the frequency of PNI was high in patients with gastric cancer who underwent curative gastrectomy and the proportion of PNI positivity increased with progression and clinical stage of disease. PNI may be useful in detecting patients who had poor prognosis after curative resection in gastric cancer.

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Authors and Affiliations

  1. Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey

    Ahmet Bilici MD, Mesut Seker MD, Bala Basak Oven Ustaalioglu MD, Umut Kefeli MD, Emre Yildirim MD, Taflan Salepci MD & Mahmut Gumus MD

  2. Department of Pathology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey

    Dilek Yavuzer MD

  3. Department of Gastroenterology, Kosuyolu Yuksek Ihtisas Education and Research Hospital, Istanbul, Turkey

    Fatih Muhammed Aydin MD

  4. Department of General Surgery, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey

    Mustafa Oncel MD, FASCRS(Int)

  5. Medical College of Gumushane University, Gumushane, Turkey

    Mustafa Oncel MD, FASCRS(Int)

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  1. Ahmet Bilici MD
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  2. Mesut Seker MD
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  3. Bala Basak Oven Ustaalioglu MD
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  4. Umut Kefeli MD
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  5. Emre Yildirim MD
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  6. Dilek Yavuzer MD
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  7. Fatih Muhammed Aydin MD
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  8. Taflan Salepci MD
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  9. Mustafa Oncel MD, FASCRS(Int)
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  10. Mahmut Gumus MD
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Correspondence to Ahmet Bilici MD.

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Bilici, A., Seker, M., Ustaalioglu, B.B.O. et al. Prognostic Significance of Perineural Invasion in Patients with Gastric Cancer Who Underwent Curative Resection. Ann Surg Oncol 17, 2037–2044 (2010). https://doi.org/10.1245/s10434-010-1027-y

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  • DOI: https://doi.org/10.1245/s10434-010-1027-y

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