Extramural Perineural Invasion in pT3 and pT4 Gastric Carcinomas

• Main Authors: Alejandro España-Ferrufino (Author), Leonardo S. Lino-Silva (Author), Rosa A. Salcedo-Hernández (Author)
• Format: Book
• Published: Korean Society of Pathologists & the Korean Society for Cytopathology, 2018-03-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2383-7837; 2383-7845; 10.4132/jptm.2017.11.01
• Keywords: Stomach neoplasms; Perineural invasion; Survival; Prognostic factor; Neoplasms; Pathology; RB1-214
• Source: Journal of Pathology and Translational Medicine, Vol 52, Iss 2, Pp 79-84 (2018)

Background Perineural invasion (PNI) is widely studied in malignant tumors, and its prognostic significance is well demonstrated. Most studies have focused on evaluating the mural PNI (mPNI); however, extramural PNI (ePNI) may influence the prognosis in gastric cancer. We evaluated the prognostic value of ePNI compared with mPNI in gastric cancer in this observational comparative cross-sectional study. Methods Seventy-three pT3 and pT4 gastric carcinomas with PNI were evaluated. Forty-eight (65.7%) were in the mPNI group and the remaining in the ePNI group. Results Clinicopathologic characteristics between the two groups were similar, except for the outcomes. The 5-year disease-specific survival (DSS) rate was 64% for the mPNI group and 50% for the ePNI group (p=.039), a difference that did not remain significant in multivariate analysis. The only independent adverse prognostic factor in multivariate analysis was the presence of lymph node metastasis (hazard ratio, 1.757; 95% confidence interval, 1.082 to 2.854; p=.023). Conclusions We demonstrated the prognostic effect of ePNI for DSS in surgically resected pT3-pT4 gastric cancer patients. ePNI could be considered in the staging and prognostic systems of gastric cancer to stratify patients with a high risk of recurrence.