Can Lymphovascular and Perineural Invasion be Additional Staging Criteria in Colorectal Cancer?

OBJECTIVE To identify additional staging information, venous, lymphatic, and neural invasion as potential prognostic factors in colorectal cancer (CRC). STUDY DESIGN A descriptive study. Place and Duration of the Study: University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey; from May 2007 to June 2019. METHODOLOGY Retrospective analyses were performed on 855 CRC patients, who were treated with surgery. Patient and treatment characteristics, lymphovascular (LVI), and perineural (PNI) invasion were documented. The impact of LVI and PNI was determined using Cox proportional hazards model. RESULTS The cohort examined had 346 (40.5%) LVI and 150 (17.5%) PNI positive patients. After surgery, mortality was 18.4% for LVI and 8% for PNI patients. Although increased ASA score (for ASA 2 hazard ratio [HR]=0.555, p=0.001 and ASA 3-4 HR=0.723, p=0.014), adjuvant chemotherapy (HR=2.5, p