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The prognostic and predictive significance of perineural invasion in stage I to III colon cancer: a propensity score matching-based analysis.

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Title: The prognostic and predictive significance of perineural invasion in stage I to III colon cancer: a propensity score matching-based analysis.
Authors: Chu, Chun-Hui1 (AUTHOR), Lai, I-Li1 (AUTHOR), Jong, Bor-Kang1 (AUTHOR), Chiang, Sum-Fu1 (AUTHOR), Tsai, Wen-Sy1 (AUTHOR), Hsieh, Pao-Shiu1 (AUTHOR), Yeh, Chien-Yuh1 (AUTHOR), You, Jeng-Fu1 (AUTHOR) jenodyssey@gmail.com
Source: World Journal of Surgical Oncology. 5/11/2024, Vol. 22 Issue 1, p1-11. 11p.
Subject Terms: *COLON cancer, *CHEMOTHERAPY complications, *ADJUVANT chemotherapy, *PROPENSITY score matching, *OVERALL survival
Geographic Terms: TAIWAN
Abstract: Background: Colorectal cancer (CRC) presents with varying prognoses, and identifying factors for predicting metastasis and outcomes is crucial. Perineural invasion (PNI) is a debated prognostic factor for CRC, particularly in stage I-III patients, but its role in guiding adjuvant chemotherapy for node-positive colon cancer remains uncertain. Methods: We conducted a single-center study using data from the Colorectal Section Tumor Registry Database at Chang Gung Memorial Hospital, Taiwan. This prospective study involved 3,327 CRC patients, 1,536 of whom were eligible after application of the exclusion criteria, to investigate the prognostic value of PNI in stage I-III patients and its predictive value for node-positive/negative cancer patients receiving adjuvant chemotherapy. Propensity score matching (PSM) was used to minimize selection bias, and follow-up was performed with standardized procedures. Results: PNI-positive (PNI+) tumors were associated with higher preoperative CEA levels and more frequent adjuvant chemotherapy. After PSM, PNI + tumors were associated with marginally significantly lower 5-year disease-free survival (DFS) and significantly lower overall survival (OS) rates in stages III CRC. However, no significant differences were observed in stages I and II. Subgroup analysis showed that among PNI + tumors, only poorly differentiated tumors had higher odds of recurrence. PNI did not predict outcomes in node-negative colon cancer. Adjuvant chemotherapy benefited PNI + patients with node-positive but not those with node-negative disease. Conclusions: Our study indicates that PNI is an independent poor prognostic factor in stage III colon cancer but does not predict outcomes in node-negative disease. Given the potential adverse effects of adjuvant chemotherapy, our findings discourage its use in node-negative colon cancer when PNI is present. [ABSTRACT FROM AUTHOR]
Copyright of World Journal of Surgical Oncology is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The prognostic and predictive significance of perineural invasion in stage I to III colon cancer: a propensity score matching-based analysis.
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  Data: <searchLink fieldCode="AR" term="%22Chu%2C+Chun-Hui%22">Chu, Chun-Hui</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lai%2C+I-Li%22">Lai, I-Li</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jong%2C+Bor-Kang%22">Jong, Bor-Kang</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chiang%2C+Sum-Fu%22">Chiang, Sum-Fu</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tsai%2C+Wen-Sy%22">Tsai, Wen-Sy</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hsieh%2C+Pao-Shiu%22">Hsieh, Pao-Shiu</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Yeh%2C+Chien-Yuh%22">Yeh, Chien-Yuh</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22You%2C+Jeng-Fu%22">You, Jeng-Fu</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> jenodyssey@gmail.com</i>
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  Data: <searchLink fieldCode="JN" term="%22World+Journal+of+Surgical+Oncology%22">World Journal of Surgical Oncology</searchLink>. 5/11/2024, Vol. 22 Issue 1, p1-11. 11p.
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  Data: *<searchLink fieldCode="DE" term="%22COLON+cancer%22">COLON cancer</searchLink><br />*<searchLink fieldCode="DE" term="%22CHEMOTHERAPY+complications%22">CHEMOTHERAPY complications</searchLink><br />*<searchLink fieldCode="DE" term="%22ADJUVANT+chemotherapy%22">ADJUVANT chemotherapy</searchLink><br />*<searchLink fieldCode="DE" term="%22PROPENSITY+score+matching%22">PROPENSITY score matching</searchLink><br />*<searchLink fieldCode="DE" term="%22OVERALL+survival%22">OVERALL survival</searchLink>
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Colorectal cancer (CRC) presents with varying prognoses, and identifying factors for predicting metastasis and outcomes is crucial. Perineural invasion (PNI) is a debated prognostic factor for CRC, particularly in stage I-III patients, but its role in guiding adjuvant chemotherapy for node-positive colon cancer remains uncertain. Methods: We conducted a single-center study using data from the Colorectal Section Tumor Registry Database at Chang Gung Memorial Hospital, Taiwan. This prospective study involved 3,327 CRC patients, 1,536 of whom were eligible after application of the exclusion criteria, to investigate the prognostic value of PNI in stage I-III patients and its predictive value for node-positive/negative cancer patients receiving adjuvant chemotherapy. Propensity score matching (PSM) was used to minimize selection bias, and follow-up was performed with standardized procedures. Results: PNI-positive (PNI+) tumors were associated with higher preoperative CEA levels and more frequent adjuvant chemotherapy. After PSM, PNI + tumors were associated with marginally significantly lower 5-year disease-free survival (DFS) and significantly lower overall survival (OS) rates in stages III CRC. However, no significant differences were observed in stages I and II. Subgroup analysis showed that among PNI + tumors, only poorly differentiated tumors had higher odds of recurrence. PNI did not predict outcomes in node-negative colon cancer. Adjuvant chemotherapy benefited PNI + patients with node-positive but not those with node-negative disease. Conclusions: Our study indicates that PNI is an independent poor prognostic factor in stage III colon cancer but does not predict outcomes in node-negative disease. Given the potential adverse effects of adjuvant chemotherapy, our findings discourage its use in node-negative colon cancer when PNI is present. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of World Journal of Surgical Oncology is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: 5/11/2024
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