The impact of lymphovascular invasion on recurrence-free survival in high-risk stage II colorectal cancer patients treated with adjuvant therapy.

Abstract

Objective: Lymphovascular invasion (LVI) may affect disease recurrence after operation for colorectal cancer (CRC). Whether LVI is an exact prognostic variable remains uncertain. This research aimed to investigate the relationship between clinicopathologic factors, disease-free survival (DFS), and overall survival (OS) in patients with high-risk stage II colon cancer who underwent adjuvant treatments, focusing on LVI. Materials and Methods: This study retrospectively investigated 173 patients who underwent operation for stage II tumors from September 2000 and December 2013. All patients received postoperative adjuvant therapy. The distinction among factors was calculated by a chi-square test. Survival probabilities were predicted with the Kaplan-Meier method, and group comparisons were applied with the log-rank test. Furthermore, univariate and multivariate cox regression analysis were used to determine the most substantial risk elements. Results: LVI was identified in 26 of 173 patients (15%) and was significantly related with positive perineural invasion (PNI) (p<0.001). There were no considerable differences among LVI and other clinicopathologic factors. LVI-positive patients had significantly lower DFS than LVI negative patients, with a hazard ratio of 2.83 (95% CI 1.24-6.48). The five-year survival rate of the LVI-positive group was substantially lower than for those who were LVI negative (p=0.004). Conclusion: In this research, LVI was a meaningful prognostic variable for DFS, but not for OS. This study revealed a prognostic value of LVI for DFS in patients with high-risk stage II tumor who underwent adjuvant treatments.

Lymphovascular invasion in colorectal cancers: can we predict it preoperatively?

“…This study aimed to identify possible preoperative factors likely to be associated with LVI in CRC. Studies have indicated that LVI is present in 5.2% to 89.5% of patients, depending on the CRC stage [17][18][19][20][21]. In our study, this proportion was 53.13%, which is consistent with the literature.…”

Identification of genomic alterations of perineural invasion in patients with stage II colorectal cancer

“…However, the TNM stage alone does not accurately predict the prognosis and distinguish whether the patient should receive adjuvant chemotherapy, particularly in patients with stage II CRC. Among CRC, TNM stage II constitutes a very wide spectrum and the 5-year overall survival of surgically resected patients ranges between 75 and 80% [3][4] . Plenty of clinicopathological features have been associated with a high risk of recurrence and metastasis in stage II CRC, among which perineural invasion (PNI) has been associated with a poor outcome [5][6][7] and the postoperative survival rate of stage II CRC patients with PNI was supposed to be more similar to that of stage III [8] .…”

<p>Identification of Genomic Alterations of Perineural Invasion in Patients with Stage II Colorectal Cancer</p>

“…Among CRC, TNM stage II constitutes a very wide spectrum and the 5-year overall survival of surgically resected patients ranges between 75% and 80%. 3,4 Plenty of clinicopathological features have been associated with a high risk of recurrence and metastasis in stage II CRC, among which perineural invasion (PNI) has been associated with a poor outcome and the postoperative survival rate of stage II CRC patients with PNI was supposed to be more similar to that of stage III. [5][6][7][8] Complex signaling between tumor cells, the nerves, and stromal cells is probably related to the pathogenesis of PNI.…”