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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 6/2015

01-06-2015 | Original Article

Prognostic Value of Perineural Invasion in Colorectal Cancer: A Meta-Analysis

Authors: Yuchong Yang, Xuanzhang Huang, Jingxu Sun, Peng Gao, Yongxi Song, Xiaowan Chen, Junhua Zhao, Zhenning Wang

Published in: Journal of Gastrointestinal Surgery | Issue 6/2015

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Abstract

Background

The prognostic value of perineural invasion (PNI) in colorectal cancer (CRC) does not reach a consensus.

Methods

A comprehensive literature search for relevant reports published up to October 2014 was performed using the electronic databases: PubMed, Embase, and Web of Science. The pooled hazard ratio (HR) with 95 % confidence intervals (CI) was used to estimate the prognostic effects.

Result

Thirty-eight studies comprising 12,661 CRC patients were analyzed. Our results showed that PNI is significantly associated with poor prognosis in OS (overall survival) (HR = 2.07, 95 % CI = 1.87–2.29, P < 0.01) and DFS (disease-free survival) (HR = 2.23, 95 % CI = 1.79–2.78, P < 0.01). There was no significant prognostic difference in DFS between stage II CRC patients with PNI(+) and stage III patients (HR = 1.67, 95 % CI = 0.53–5.25, P = 0.38). Further subgroup analysis revealed that the significance of the association between PNI and worse prognosis in CRC patients is not affected by many factors, including geographic setting, PNI positive rate, treatment, TNM stage, tumor site, and quality of the study.

Conclusions

The meta-analysis indicates that PNI is a poor prognostic factor in CRC patients. The postoperative survival of stage II CRC patients with PNI(+) is probably more similar to that of stage III patients. Currently available adjuvant therapy should be considered in stage II CRC patients with PNI(+).
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Metadata
Title
Prognostic Value of Perineural Invasion in Colorectal Cancer: A Meta-Analysis
Authors
Yuchong Yang
Xuanzhang Huang
Jingxu Sun
Peng Gao
Yongxi Song
Xiaowan Chen
Junhua Zhao
Zhenning Wang
Publication date
01-06-2015
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 6/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-015-2761-z

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