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Perineural invasion is associated with poor prognosis of colorectal cancer: a retrospective cohort study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Perineural invasion (PNI) is associated with poor prognosis in a variety of cancers. Our aim was to determine the clinicopathological factors associated with PNI in colorectal cancer (CRC) and its impact on patient survival.

Material and methods

The clinical data of 1412 patients diagnosed with CRC from July 2013 to July 2016 were retrospectively collected. PNI was determined based on hematoxylin-eosin staining. The relationships of PNI with various clinicopathological factors and prognosis were analyzed.

Results

The incidence of PNI in the entire cohort was 21.5%. PNI was significantly more common in patients with lower tumor differentiation, higher tumor stage, vascular invasion, TNM stage, tumor diameter, MMR/KRAS/NRAS/BRAF mutation, and more positive lymph nodes. Logistic regression analysis showed that T stage, vascular invasion, tumor diameter, and MMR were the main influencing factors of PNI. Cox regression analysis showed that poor tumor differentiation, N stage, TNM stage, PNI, and BRAF status were independent prognostic factors for OS. The OS, CSS, and PFS rate of the PNI (−) group was higher than that of the PNI (+) group, and the difference was statistically significant (P < 0.001).

Conclusion

PNI in patients with colorectal cancer is significantly associated with T stage, TNM stage, vessel invasion, tumor diameter, MMR status, and BRAF mutation. PNI status is an independent prognostic factor for CRC. Assessing the postoperative PNI status may help predict prognosis and determine further treatment options for these patients.

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Funding

This study was supported by grants from the Science and Technology Department of Hubei Province (No. 2018CFC884), the Wu Jieping Medical Foundation of China (No. 320.2710.1843), and Clinical Research Physician Program of Tongji Medical College, HUST.

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Author notes

  1. Yinghao Cao, Shenghe Deng and Lizhao Yan contributed equally to this work and considered as co-first authors.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 JieFang Avenue, Wuhan, 430022, Hubei, China

    Yinghao Cao, Shenghe Deng, Lizhao Yan, Junnan Gu, Jiang Li, Ke Wu & Kailin Cai

Authors
  1. Yinghao Cao
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  2. Shenghe Deng
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  3. Lizhao Yan
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  4. Junnan Gu
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  5. Jiang Li
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  6. Ke Wu
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Contributions

Yinghao Cao, Shenghe Deng, Lizhao Yan, Junnan Gu, Fuwei Mao, Jiang Li, Ke Wu, and Kailin Cai meet all the criteria for the definition of authorship and contributed substantially to the manuscript. Yinghao Cao, Shenghe Deng, and Lizhao Yan contributed equally to this work and they were considered co-first authors. Ke Wu and Kailin Cai are the correspondent authors.

Corresponding authors

Correspondence to Ke Wu or Kailin Cai.

Ethics declarations

The study was approved by the ethics committee of Wuhan Union Medical College Hospital (No. 2018-S377) and all patients signed an informed consent to participate.

Conflict of interest

The authors declare that they have no conflict of interest.

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Cao, Y., Deng, S., Yan, L. et al. Perineural invasion is associated with poor prognosis of colorectal cancer: a retrospective cohort study. Int J Colorectal Dis 35, 1067–1075 (2020). https://doi.org/10.1007/s00384-020-03566-2

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  • DOI: https://doi.org/10.1007/s00384-020-03566-2

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