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Inclusion of Perineural Invasion with AJCC-TNM Staging: Outcomes from a South Asian Cohort of Curatively Treated Gastric Cancer Patients

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Abstract

Background

The incidence of perineural invasion (PNI) in patients with gastric cancer (GC) is high, and patients with PNI positive disease have a poor prognosis compared to PNI-negative disease. The present study aims to study the incidence and evaluate the impact of PNI on the survival outcome of a cohort of South Asian GC patients.

Material and Methods

All consecutive patients undergoing curative gastrectomy were included in the study. The incidence of PNI and correlation with different clinico-pathological features and overall survival was performed.

Results

A total of 59.54% had PNI-positive disease and the median OS of PNI + ve patients was 29.3 months, while it was not reached in PNI-ve patients. The PNI positivity was a significant prognostic factor for overall survival both on univariate and multivariate analysis. On TNM-PNI staging, those with TNM stage I/II patients with PNI + ve disease had similar OS to all stage III patients (p = 0.835) and were worse than that of PNI-ve patients (p < 0.05).

Conclusion

The incidence of PNI in gastric cancer is high. The inclusion of PNI with AJCC-TNM staging may better stratify prognostic staging in curatively treated gastric cancer patients.

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Acknowledgements

We acknowledge the contribution of Mr. Tushar Ranjan Pradhan in designing the surgical oncology database and Ms Rukchhanda Nayak and Mr Prakash Palei for data keeping and retrieval.

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Authors and Affiliations

  1. Department of Surgical Oncology, All India Institute of Medical Sciences, Bhubaneswar, India

    Dillip Kumar Muduly, Madhabananda Kar, Mahesh Sultania & Mohammed Imaduddin

  2. Department of Pathology & Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, India

    Mohammed Shahin & Susama Patra

  3. Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India

    Vishwajeet Singh

  4. Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, India

    Sudipta Mohakud

  5. Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, India

    Hemant Kumar Nayak & Manas Kumar Panigraphi

  6. Department of Radiotherapy, All India Institute of Medical Sciences, Bhubaneswar, India

    Saroj Kumar Das Majumdar & Dilip Kumar Parida

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  1. Dillip Kumar Muduly
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  2. Madhabananda Kar
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Correspondence to Dillip Kumar Muduly.

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Muduly, D.K., Kar, M., Sultania, M. et al. Inclusion of Perineural Invasion with AJCC-TNM Staging: Outcomes from a South Asian Cohort of Curatively Treated Gastric Cancer Patients. J Gastrointest Canc 54, 606–613 (2023). https://doi.org/10.1007/s12029-022-00838-8

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  • DOI: https://doi.org/10.1007/s12029-022-00838-8

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