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Perineural invasion through the sheath in posttherapy esophagectomy specimens predicts poor survival in patients with esophageal squamous cell carcinoma.
- Source :
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European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2017 Oct; Vol. 43 (10), pp. 1970-1976. Date of Electronic Publication: 2017 Aug 03. - Publication Year :
- 2017
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Abstract
- Background: The prognostic impact of perineural invasion (PNI) in patients with esophageal cancer who receive neoadjuvant chemoradiotherapy (nCRT) remains unclear.<br />Methods: A thorough pathological review of PNI was performed on post-nCRT esophagectomy specimens obtained from non-ypT0 patients with esophageal squamous cell carcinoma (ESCC). When PNI was identified, it was classified according to the presence or absence of penetration through the nerve sheath (i.e., PNI surrounding the nerve sheath [PNI-SS] versus PNI penetrating through the nerve sheath [PNI-TS]). The impact of PNI on overall survival (OS) was assessed in combination with clinical and pathological risk factors.<br />Results: A total of 177 eligible patients were identified between 1998 and 2008. PNI was identified in 43.5% (77/177) of participants. Of them, 33 and 44 had PNI-SS and PNI-TS, respectively. The 5-year OS rate of patients with PNI-TS was significantly lower (6.7%) than that observed in those without PNI (30.6%, P < 0.001). However, the 5-year OS observed in the latter group did not differ significantly from that of patients with PNI-SS (26%, P = 0.68). Multivariate analysis identified PNI-TS (hazard ratio [HR] = 1.965, P = 0.02), LVI (HR = 1.514, P = 0.048), and ypN2 stage (HR = 2.39, P = 0.007) as independent adverse prognostic factors for OS.<br />Conclusions: The presence of PNI-TS after nCRT is associated with poor survival. A thorough assessment of distinct PNI patterns (i.e., PNI-TS versus PNI-SS) should be part of the routine post-nCRT histopathological work-up of ESCC patients.<br /> (Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
- Subjects :
- Carcinoma, Squamous Cell mortality
Carcinoma, Squamous Cell therapy
Chemoradiotherapy
Disease-Free Survival
Esophageal Neoplasms mortality
Esophageal Neoplasms therapy
Esophageal Squamous Cell Carcinoma
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Invasiveness
Neoplasm Staging
Prognosis
Retrospective Studies
Risk Factors
Survival Rate trends
Taiwan epidemiology
Treatment Outcome
Carcinoma, Squamous Cell pathology
Esophageal Neoplasms pathology
Esophagectomy methods
Nervous System Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2157
- Volume :
- 43
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 28801062
- Full Text :
- https://doi.org/10.1016/j.ejso.2017.07.014