Oncology Medical News about colorectal cancer;perineural invasion;independent predictor of outcome

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Perineural invasion is an independent predictor of outcome in colorectal cancer
Journal of Clinical Oncology, 09/10/09

Liebig C et al. – PNI is grossly underreported in CRC and could serve as an independent prognostic factor of outcomes in these patients. PNI should be considered when stratifying CRC patients for adjuvant treatment.

Methods

269 consecutive patients who had CRC
Tumors were rereviewed for PNI by a pathologist blinded to the patients' outcomes

Results

PNI was identified in less than 0.5% of the initial pathology reports
22% of tumors in our series were found to be PNI positive
The 5-year DFS rate was 4-fold greater for patients with PNI-negative tumors versus those with PNI-positive tumors (65% v 16%, respectively)
The 5-year overall survival rate was 72% for PNI-negative tumors versus 25% for PNI-positive tumors
On multivariate analysis, PNI was an independent prognostic factor for both cancer-specific overall and DFS
In a subset analysis comparing patients with node-negative disease with patients with stage III disease, the 5-year disease-free survival rate was 56% for stage III patients versus 29% for patients with node-negative, PNI-positive tumors
Similar results were seen for OS

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