Perineural Invasion Is a Strong Prognostic Factor but Not a Predictive Factor of Response to Adjuvant Chemotherapy in Node-Negative Colon Cancer

Abstract

PurposeTo validate the prognostic value and evaluate the predictive value of response to adjuvant chemotherapy of perineural invasion (PNI) in node-negative colon cancer using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) 18 tumor registry database.MethodsPatients diagnosed with colon cancer from the SEER database between January 1, 2010 and December 31, 2015 were identified. Chi-square analysis was performed to evaluate different demographic and clinical features of patients between PNI-negative (PNI (−)) and PNI-positive (PNI (+)) groups. Univariate and multivariate Cox proportional hazard regression models were built to examine the relationship of demographic and clinical features and survival outcomes with the hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsIn total, 57,255 node-negative colon cancer patients were extracted from the SEER database. The receipt of chemotherapy was not an independent prognostic factor for CSS in T3 colon cancer with or without the presence of PNI (P >0.05). The receipt of chemotherapy was independently associated with 34.0% decreased risk of cancer-specific mortality compared with those without the receipt of chemotherapy in T4 colon cancer without the presence of PNI (HR = 0.660, 95%CI = 0.559–0.779, P <0.001); the receipt of chemotherapy was independently associated with 36.0% decreased risk of cancer-specific mortality compared with those without the receipt of chemotherapy in T4 colon cancer with the presence of PNI (HR = 0.640, 95%CI = 0.438–0.935, P = 0.021).ConclusionsThe present study demonstrated the poor prognosis of PNI (+) in both stage I and II colon cancer. However, the presence of PNI was not a predictive factor of response to adjuvant chemotherapy in node-negative colon cancer.

Let-7 microRNAs Are Possibly Associated with Perineural Invasion in Colorectal Cancer by Targeting IGF Axis

“…Perineural invasion (PNI) is a possible course for metastatic spread in a variety of cancers, including CRC, and is usually a poor prognostic factor [ 16 ]. Moreover, PNI presence has been associated with a higher T and N stage, histological features of adenocarcinoma, and higher tumor grade [ 17 ].…”

The effect of adjuvant chemotherapy on survival in node negative colorectal cancer with or without perineural invasion: a systematic review and meta-analysis

“…DFS was examined in 4 studies including 344 PNI + patients (with 62 receiving ACT) and 3,285 PNI- patients (with 1,191 receiving ACT) ( 29 , 32 – 34 ). Two studies with 2,461 PNI + (262 ACT) and 55,257 PNI- (4,675 ACT) patients analyzed DSS ( 15 , 35 ). Recurrence-free survival (RFS) was assessed in 2 studies: one with 108 PNI + patients (43 ACT) and another with 2,498 PNI- patients (471 ACT) ( 15 , 29 ).…”

“…Five studies involving 91,828 patients provided data on the impact of PNI on survival ( 28 , 32 – 35 ). In three studies, PNI was found to decrease DFS (HR = 1.94, 95% CI = 1.52–2.47, p < 0.001).…”

Interaction analysis of high-risk pathological features on adjuvant chemotherapy survival benefit in stage II colon cancer patients: a multi-center, retrospective study

“…A systemic review involving 58 studies and 22,900 patients found that PNI is correlated with decreased 5-year DFS (HR 2.35, 95% CI, 1.97–3.08), CSS (HR 1.91, 95% CI, 1.50–2.42) and OS (HR 1.85, 95% CI, 1.63–2.12) in colorectal cancer [ 18 ]. Focusing on stage II colon cancer, Tu et al [ 19 ] demonstrated that PNI is an prognostic factor for CSS independent of T stage, age, tumor grade, etc. in 31805 stage II colon cancer patients from SEER database.…”