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Perineural invasion after preoperative chemotherapy predicts poor survival in patients with locally advanced gastric cancer: gene expression analysis with pathologic validation
American Journal of Clinical Oncology, 08/07/09

Jhawer M et al. - In a study to examine gene expression profiles and clinicopathologic features of pts with gastric cancer who received preoperative chemotherapy to identify prognostic markers, it was found that the presence of perineural invasion (PNI) after preoperative chemotherapy is associated with poor survival. Presence of PNI provides additional prognostic importance to posttreatment pathologic stage and may indicate treatment resistance. Understanding the molecular events associated with PNI may provide insight into new therapeutic agents for these pts with resistant tumors.

Methods

38 pts with locally advanced gastric cancer received preoperative chemotherapy.
12 fresh-frozen tumor samples were available for RNA expression analysis.
Differential gene expression between tumors with and without PNI was identified and correlated with clinicopathologic features.

Results

Preliminary hierarchical clustering suggested a separation between long- and short-term survivors.
Close association between PNI and overall survival was identified and validated immunohistochemically in 31 completely resected gastric tumors.
5-yr survival for pts with PNI and without PNI was 5% and 65%, respectively.
PNI added significant prognostic value to posttreatment pathologic stage.
Differential gene expression profile for PNI and non-PNI tumors identified 111 potentially relevant genes.

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