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The significance of peri-neural invasion in patients with gallbladder carcinoma after curative surgery: a 10 year experience in China

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Abstract

The significance of peri-neural invasion (PNI) in patients with gallbladder carcinoma (GBC) after curative surgery remains unknown. Current study was performed to evaluate the significance of PNI in resected GBC patients in terms of tumor-related biological features and long-term survival. Patients with GBC between September 2010 and September 2020 were reviewed and analyzed. SPSS 25.0 software were used for statistical analysis. A total of 324 resected GBC patients were identified (No. PNI: 64). An elevated preoperative Ca19.9 level (P = 0.001), obstructive jaundice (P = 0.001), liver invasion (P < 0.0001), lymph-vascular invasion (P < 0.0001), lymph-node metastasis (P < 0.0001), and poor or moderate differentiation status (P = 0.036) were more frequently detected in patients with PNI. Major hepatectomy (P = 0.019), bile duct resection (P < 0.0001), combined multi-visceral resections (P = 0.001), and combined major vascular resections and reconstructions (P = 0.002) were also more frequently detected. However, a significantly lower R0 rate (P < 0.0001) was acquired in patients with PNI. Patients with PNI were generally more advanced disease and shared a much worse prognosis even after matching. PNI was an independent prognostic factor of disease-free survival as well as an independent predictor of early recurrence. Postoperative adjuvant chemotherapy has brought an obvious survival benefit in resected GBC patients with PNI. PNI could be regarded as an indicator of worse prognosis and could serve as an independent predictor of early recurrence. Postoperative adjuvant chemotherapy was correlated with an improved survival for resected GBC patients with PNI. Upcoming multicenter studies covering various races are warranted for further validation.

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Data availability

All data were extracted from the cancer database of our hospital and they can be provided if required.

Abbreviations

GBC:

Gallbladder carcinoma

PNI:

Peri-neural invasion

FLRV:

Functional liver remanent volume

AJCC:

American Joint on Committee on Cancer

NCCN:

National Comprehensive Cancer Network

PSM:

Propensity score matching

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Funding

This study was Supported by 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYJC21046); 1.3.5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University (2021HXFH001); Natural Science Foundation of Sichuan Province (2022NSFSC0806); National Natural Science Foundation of China for Young Scientists Fund (82203650, 82203782), Sichuan Science and Technology Program (2021YJ0132, 2021YFS0100); The fellowship of China Postdoctoral Science Foundation (2021M692277); Sichuan University-Zigong School-local Cooperation project (2021CDZG-23); Sichuan University-Sui Lin School-local Cooperation project (2022CDSN-18); Science and Technology project of the Health planning committee of Sichuan (21PJ046); Post-Doctor Research Project, West China Hospital, Sichuan University (2020HXBH127). Funding source has no role in design and preparation of the manuscript.

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Author notes

  1. Hai-Jie Hu and Fei Liu have contributed equally to this work.

Authors and Affiliations

  1. Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Tian-Run Lv, Hai-Jie Hu, Fei Liu, Wen-Jie Ma, Yan-Wen Jin & Fu-Yu Li

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  1. Tian-Run Lv
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  2. Hai-Jie Hu
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  3. Fei Liu
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Contributions

T-RL, H-JH, and FL contributed equally to the study. T-RL contributed to data acquisition and drafted the manuscript. FL and H-JH contributed to the literature review, manuscript editing, and subsequent minor revision. W-JM and Y-WJ were involved in editing the manuscript. F-YL contributed to the study design and revision of the manuscript.

Corresponding author

Correspondence to Fu-Yu Li.

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All authors declare that they have no conflicts of interest to disclose.

Research involving human participants and/or animals and Informed consent

This study was approved by institutional ethics review board of West China Hospital and the inform consent was allowed to be waived by the ethics review board of West China Hospital, Sichuan university.

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Lv, TR., Hu, HJ., Liu, F. et al. The significance of peri-neural invasion in patients with gallbladder carcinoma after curative surgery: a 10 year experience in China. Updates Surg 75, 1123–1133 (2023). https://doi.org/10.1007/s13304-023-01519-2

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  • DOI: https://doi.org/10.1007/s13304-023-01519-2

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