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J Pathol Transl Med. 2018 Mar;52(2):79-84. English. Original Article. https://doi.org/10.4132/jptm.2017.11.01
España-Ferrufino A , Lino-Silva LS , Salcedo-Hernández RA .
Department of Gastrointestinal Pathology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico. saul.lino.sil@gmail.com
Department of Surgical Oncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
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.

Copyright © 2019. Korean Association of Medical Journal Editors.