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The prognostic effect of perineural invasion in esophageal squamous cell carcinoma.

Chen JW, Xie JD, Ling YH, Li P, Yan SM, Xi SY, Luo RZ, Yun JP, Xie D, Cai MY - BMC Cancer (2014)

Bottom Line: Patients with PNI-negative tumors exhibited a 1.7-fold increase in five-year recurrence-free survival compared with patients with PNI-positive tumors (0.531 v 0.305, respectively; P < 0.0001).In the multivariate analysis, PNI was an independent prognostic factor for overall survival (P = 0.027).The C-index estimate for the combined model (PNI, gender and pN status) was a significant improvement on the C-index estimate of the clinicopathologic model alone (0.739 v 0.706, respectively).

View Article: PubMed Central - HTML - PubMed

Affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. caimuyan@hotmail.com.

ABSTRACT

Background: Perineural invasion (PNI) is correlated with adverse survival in several malignancies, but its significance in esophageal squamous cell carcinoma (ESCC) remains to be clearly defined. The objective of this study was to determine the association between PNI status and clinical outcomes.

Methods: We retrospectively evaluated the PNI of 433 patients with ESCC treated with surgery between 2000 and 2007 at a single academic center. The resulting data were analyzed using Spearman's rank correlation, the Kaplan-Meier method, Cox proportional hazards regression modeling and Harrell's concordance index (C-index).

Results: PNI was identified in 209 of the 433 (47.7%) cases of ESCC. The correlation analysis demonstrated that PNI in ESCC was significantly correlated with tumor differentiation, infiltration depth, pN classification and stage (P < 0.05). The five-year overall survival rate was 0.570 for PNI-negative tumors versus 0.326 for PNI-positive tumors. Patients with PNI-negative tumors exhibited a 1.7-fold increase in five-year recurrence-free survival compared with patients with PNI-positive tumors (0.531 v 0.305, respectively; P < 0.0001). In the subset of patients with node-negative disease, PNI was evaluated as a prognostic predictor as well (P < 0.05). In the multivariate analysis, PNI was an independent prognostic factor for overall survival (P = 0.027). The C-index estimate for the combined model (PNI, gender and pN status) was a significant improvement on the C-index estimate of the clinicopathologic model alone (0.739 v 0.706, respectively).

Conclusions: PNI can function as an independent prognostic factor of outcomes in ESCC patients, and the PNI status in primary ESCC specimens should be considered for therapy stratification.

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The association between perineural invasion and ESCC patients’ survival (log-rank test). Kaplan-Meier survival analysis of perineural invasion for overall survival (A) and recurrence-free survival (B) in ESCC patients.
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Figure 2: The association between perineural invasion and ESCC patients’ survival (log-rank test). Kaplan-Meier survival analysis of perineural invasion for overall survival (A) and recurrence-free survival (B) in ESCC patients.

Mentions: The prognostic significance of PNI as well as other clinicopathologic variables was investigated by univariate analyses. The PNI status (P < 0.0001), patient gender (P = 0.016), tumor differentiation (P = 0.021), pT status (P = 0.002), pN status (P < 0.0001) and tumor stage (P < 0.0001) influenced the patients’ overall survival (Table 2). Patient age and the size and location of the tumor did not significantly affect outcomes. The 5-year overall survival rate was greater for patients with PNI-negative tumors than for patients with PNI-positive tumors (0.570 v 0.326, respectively; P < 0.0001; Figure 2A). Similar results were found for recurrence-free survival. Patients with PNI-negative tumors exhibited a 1.7-fold increase in five-year recurrence-free survival compared with patients with PNI-positive tumors (0.531 v 0.305, respectively; P < 0.0001; Figure 2B).


The prognostic effect of perineural invasion in esophageal squamous cell carcinoma.

Chen JW, Xie JD, Ling YH, Li P, Yan SM, Xi SY, Luo RZ, Yun JP, Xie D, Cai MY - BMC Cancer (2014)

The association between perineural invasion and ESCC patients’ survival (log-rank test). Kaplan-Meier survival analysis of perineural invasion for overall survival (A) and recurrence-free survival (B) in ESCC patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4016635&req=5

Figure 2: The association between perineural invasion and ESCC patients’ survival (log-rank test). Kaplan-Meier survival analysis of perineural invasion for overall survival (A) and recurrence-free survival (B) in ESCC patients.
Mentions: The prognostic significance of PNI as well as other clinicopathologic variables was investigated by univariate analyses. The PNI status (P < 0.0001), patient gender (P = 0.016), tumor differentiation (P = 0.021), pT status (P = 0.002), pN status (P < 0.0001) and tumor stage (P < 0.0001) influenced the patients’ overall survival (Table 2). Patient age and the size and location of the tumor did not significantly affect outcomes. The 5-year overall survival rate was greater for patients with PNI-negative tumors than for patients with PNI-positive tumors (0.570 v 0.326, respectively; P < 0.0001; Figure 2A). Similar results were found for recurrence-free survival. Patients with PNI-negative tumors exhibited a 1.7-fold increase in five-year recurrence-free survival compared with patients with PNI-positive tumors (0.531 v 0.305, respectively; P < 0.0001; Figure 2B).

Bottom Line: Patients with PNI-negative tumors exhibited a 1.7-fold increase in five-year recurrence-free survival compared with patients with PNI-positive tumors (0.531 v 0.305, respectively; P < 0.0001).In the multivariate analysis, PNI was an independent prognostic factor for overall survival (P = 0.027).The C-index estimate for the combined model (PNI, gender and pN status) was a significant improvement on the C-index estimate of the clinicopathologic model alone (0.739 v 0.706, respectively).

View Article: PubMed Central - HTML - PubMed

Affiliation: Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. caimuyan@hotmail.com.

ABSTRACT

Background: Perineural invasion (PNI) is correlated with adverse survival in several malignancies, but its significance in esophageal squamous cell carcinoma (ESCC) remains to be clearly defined. The objective of this study was to determine the association between PNI status and clinical outcomes.

Methods: We retrospectively evaluated the PNI of 433 patients with ESCC treated with surgery between 2000 and 2007 at a single academic center. The resulting data were analyzed using Spearman's rank correlation, the Kaplan-Meier method, Cox proportional hazards regression modeling and Harrell's concordance index (C-index).

Results: PNI was identified in 209 of the 433 (47.7%) cases of ESCC. The correlation analysis demonstrated that PNI in ESCC was significantly correlated with tumor differentiation, infiltration depth, pN classification and stage (P < 0.05). The five-year overall survival rate was 0.570 for PNI-negative tumors versus 0.326 for PNI-positive tumors. Patients with PNI-negative tumors exhibited a 1.7-fold increase in five-year recurrence-free survival compared with patients with PNI-positive tumors (0.531 v 0.305, respectively; P < 0.0001). In the subset of patients with node-negative disease, PNI was evaluated as a prognostic predictor as well (P < 0.05). In the multivariate analysis, PNI was an independent prognostic factor for overall survival (P = 0.027). The C-index estimate for the combined model (PNI, gender and pN status) was a significant improvement on the C-index estimate of the clinicopathologic model alone (0.739 v 0.706, respectively).

Conclusions: PNI can function as an independent prognostic factor of outcomes in ESCC patients, and the PNI status in primary ESCC specimens should be considered for therapy stratification.

Show MeSH
Related in: MedlinePlus