Combining perineural invasion with staging improve the prognostic accuracy in colorectal cancer: a retrospective cohort study

被引:3
作者
Zhang, Bin [1 ,2 ,3 ]
Lin, Yanyun [1 ,2 ,3 ]
Wang, Chao [4 ]
Chen, Zexian [1 ,2 ,3 ]
Huang, Tianze [1 ,2 ,3 ]
Chen, Hao [1 ,2 ,3 ]
Wang, Guannan [4 ]
Lan, Ping [1 ,2 ,3 ]
He, Xiaowen [1 ,2 ,3 ]
He, Xiaosheng [1 ,2 ,3 ]
机构
[1] Sun Yat Sen Univ, Affiliated Hosp 6, Dept Colorectal Surg, Guangzhou 510655, Guangdong, Peoples R China
[2] Sun Yat Sen Univ, Affiliated Hosp 6, Dept Gen Surg, Guangzhou 510655, Guangdong, Peoples R China
[3] Sun Yat Sen Univ, Affiliated Hosp 6, Guangdong Prov Key Lab Colorectal & Pelv Floor Dis, Guangzhou 510655, Guangdong, Peoples R China
[4] Sun Yat Sen Univ, Affiliated Hosp 6, Dept Pathol, Guangzhou 510655, Guangdong, Peoples R China
基金
中国国家自然科学基金; 中国博士后科学基金;
关键词
Perineural invasion; Colorectal cancer; Survival; Tumor stage; COLON-CANCER; LYMPHOVASCULAR INVASION; ADJUVANT CHEMOTHERAPY; PREDICTIVE FACTOR; TUMOR DEPOSITS; RECTAL-CANCER; VALIDATION; SURVIVAL; SURGERY;
D O I
10.1186/s12885-023-11114-8
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundCurrent guidelines only propose the importance of perineural invasion(PNI) on prognosis in stage II colon cancer. However, the prognostic value of PNI in other stages of colorectal cancer (CRC) is ambiguous.MethodsThis single-center retrospective cohort study included 3485 CRC patients who underwent primary colorectal resection between January 2013 and December 2016 at the Sixth Affiliated Hospital of Sun Yat-sen University. Associations of PNI with overall survival (OS) and disease-free survival (DFS) were evaluated using multivariable Cox proportional hazards regression models. In addition, interaction analyses were performed to explore the prognostic effects of PNI in different clinical subgroups.ResultsAfter median follow-up of 61.9 months, we found PNI was associated with poorer OS (adjusted hazard ratio [aHR], 1.290; 95% CI, 1.087-1.531) and DFS (aHR, 1.397; 95% CI, 1.207-1.617), irrespective of tumor stage. Interestingly, the weight of PNI was found second only to incomplete resection in the nomogram for risk factors of OS and DFS in stage II CRC patients. Moreover, OS and DFS were insignificantly different between stage II patients with PNI and stage III patients (both P > 0.05). PNI was found to be an independent prognostic factor of DFS in stage III CRC (aHR: 1.514; 95% CI, 1.211-1.892) as well. Finally, the adverse effect of PNI on OS was more significant in female, early-onset, and diabetes-negative patients than in their counterparts (interaction P = 0.0213, 0.0280, and 0.0186, respectively).ConclusionPNI was an important prognostic factor in CRC, more than in stage II. The survival of patients with stage II combined with perineural invasion is similar with those with stage III. PNI in stage III CRC also suggests a worse survival.
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页数:12
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