Influence of perineural invasion in predicting overall survival and disease-free survival in patients With locally advanced gastric cancer.
BACKGROUND
The aim of the present study was to evaluate the prognostic significance of perineural invasion (PNI) in locally advanced gastric cancer patients who underwent D2 gastrectomy and adjuvant chemotherapy.


METHODS
The records of a series of 103 patients undergoing D2 gastrectomy with curative intent combined with adjuvant chemotherapy from January 2004 to December 2014 were retrospectively reviewed.


RESULTS
PNI was positive in 47 (45.6%) specimens. The 1-, 3-, and 5-year overall survival rates were 81%, 55%, and 42%, respectively. The 1-, 3-, and 5-year disease-free survival (DFS) rates were 76%, 57%, and 49%, respectively. A multivariate analysis showed that age number of positive lymph nodes, T stage, and PNI were independently associated with overall survival. Regarding DFS, the multivariate analysis showed that only PNI was independently associated with DFS.


CONCLUSIONS
PNI and T stage and positive lymph nodes are independent markers of poor prognosis in patients with gastric cancer. PNI should be incorporated in the postoperative staging system for planning follow-up after surgery and in our opinion to propose more aggressive postoperative therapies in PNI-positive patients.
Department of General Surgery, University of Rome, "La Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
Paolo
P
Aurello
Department of General Surgery, University of Rome, "La Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy. Electronic address: gberardi1@gmail.com.
Giammauro
G
Berardi
Department of General Surgery, University of Rome, "La Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
Simone Maria
SM
Tierno
Department of Pathology, University of Rome, "La Sapienza", Sant'Andrea Hospital, Rome, Italy.
Gian Luca
GL
Rampioni Vinciguerra
Department of Pathology, University of Rome, "La Sapienza", Sant'Andrea Hospital, Rome, Italy.
Fabio
F
Socciarelli
Department of General Surgery, University of Rome, "La Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
Giovanni Guglielmo
GG
Laracca
Department of General Surgery, University of Rome, "La Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
Diego
D
Giulitti
Department of Pathology, University of Rome, "La Sapienza", Sant'Andrea Hospital, Rome, Italy.
Emanuela
E
Pilozzi
Department of General Surgery, University of Rome, "La Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
Giovanni
G
Ramacciato
D000367:Age Factors; D000368:Aged; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008207:Lymphatic Metastasis; D008297:Male; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D010502:Perineum / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy
Disease-free survival; Gastric cancer; Oncologic outcomes; Overall survival; Perineural invasion