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BMC Cancer
Published in: BMC Cancer 1/2014

Open Access 01-12-2014 | Research article

The prognostic effect of perineural invasion in esophageal squamous cell carcinoma

Authors: Jie-Wei Chen, Jing-Dun Xie, Yi-Hong Ling, Peng Li, Shu-Mei Yan, Shao-Yan Xi, Rong-Zhen Luo, Jing-Ping Yun, Dan Xie, Mu-Yan Cai

Published in: BMC Cancer | Issue 1/2014

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Abstract

Background

Perineural invasion (PNI) is correlated with adverse survival in several malignancies, but its significance in esophageal squamous cell carcinoma (ESCC) remains to be clearly defined. The objective of this study was to determine the association between PNI status and clinical outcomes.

Methods

We retrospectively evaluated the PNI of 433 patients with ESCC treated with surgery between 2000 and 2007 at a single academic center. The resulting data were analyzed using Spearman’s rank correlation, the Kaplan-Meier method, Cox proportional hazards regression modeling and Harrell’s concordance index (C-index).

Results

PNI was identified in 209 of the 433 (47.7%) cases of ESCC. The correlation analysis demonstrated that PNI in ESCC was significantly correlated with tumor differentiation, infiltration depth, pN classification and stage (P < 0.05). The five-year overall survival rate was 0.570 for PNI-negative tumors versus 0.326 for PNI-positive tumors. Patients with PNI-negative tumors exhibited a 1.7-fold increase in five-year recurrence-free survival compared with patients with PNI-positive tumors (0.531 v 0.305, respectively; P < 0.0001). In the subset of patients with node-negative disease, PNI was evaluated as a prognostic predictor as well (P < 0.05). In the multivariate analysis, PNI was an independent prognostic factor for overall survival (P = 0.027). The C-index estimate for the combined model (PNI, gender and pN status) was a significant improvement on the C-index estimate of the clinicopathologic model alone (0.739 v 0.706, respectively).

Conclusions

PNI can function as an independent prognostic factor of outcomes in ESCC patients, and the PNI status in primary ESCC specimens should be considered for therapy stratification.
Appendix
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Metadata
Title
The prognostic effect of perineural invasion in esophageal squamous cell carcinoma
Authors
Jie-Wei Chen
Jing-Dun Xie
Yi-Hong Ling
Peng Li
Shu-Mei Yan
Shao-Yan Xi
Rong-Zhen Luo
Jing-Ping Yun
Dan Xie
Mu-Yan Cai
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2014
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-14-313

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