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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2017.11.01    [Epub ahead of print]
Extramural Perineural Invasion in pT3 and pT4 Gastric Carcinomas
Alejandro España-Ferrufino1, Leonardo S. Lino-Silva1, Rosa A. Salcedo-Hernández2
1Department of Gastrointestinal Pathology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
2Department of Surgical Oncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
Corresponding Author: Leonardo S. Lino-Silva ,Tel: +52 55 5628-0400, Email: saul.lino.sil@gmail.com
Received: August 16, 2017;  Revised: October 20, 2017  Accepted: November 1, 2017.  Published online: November 9, 2017.
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.
Material and 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.
Clinicopathologic characteristics between groups were similar, except in the outcomes. The 5-year disease-specific survival (DSS) rate was 64% for the mPNI group and 50% for the ePNI group (p=0.039), difference that does not remain significant in the multivariate analysis., The only independent adverse prognostic factor in multivariate analysis was the presence of lymph node metastasis (HR 1.757, CI 95% 1.082-2.854, p=0.023).
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 in gastric cancer to stratify patients in a high risk of recurrence.
Key Words: gastric cancer, perineural invasion, survival, prognostic factor, cancer