Evidence map›Paper›PMID 19738119›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2009

Perineural invasion is an independent predictor of outcome in colorectal cancer.

Catherine Liebig, Gustavo Ayala, Jonathan Wilks, Gordana Verstovsek, Hao Liu, Neeti Agarwal, David H Berger, Daniel Albo

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 243 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
243citing papers in PubMed, 10 pooled it
14.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

243 citing papers in PubMed, 10 syntheses or guidelines pooled it, 542 citations in OpenAlex.

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  13. Cancer pain.Nature reviews. Disease primers · 2026
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  18. Histopathological characteristics of screen-detected colorectal cancers.Virchows Archiv : an international journal of pathology · 2026
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183 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Catherine LiebigDepartment of Surgery, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA.
Gustavo Ayala
Jonathan Wilks
Gordana Verstovsek
Hao Liu
Neeti Agarwal
David H Berger
Daniel Albo
Michael E. DeBakey VA Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePerineural invasion (PNI) is associated with decreased survival in several malignancies, but its significance in colorectal cancer (CRC) remains to be clearly defined. We evaluated PNI as a potential prognostic indicator in CRC, focusing on its significance in node-negative patients. PATIENTS AND

methodsWe identified 269 consecutive patients who had CRC resected at our institution. Tumors were re-reviewed for PNI by a pathologist blinded to the patients' outcomes. Overall and disease-free survivals were determined using the Kaplan-Meier method, with differences determined by multivariate analysis using the Cox multiple hazards model. Results were compared using the log-rank test.

resultsPNI was identified in less than 0.5% of the initial pathology reports. On rereview, 22% of tumors in our series were found to be PNI positive. The 5-year disease-free survival rate was four-fold greater for patients with PNI-negative tumors versus those with PNI-positive tumors (65% v 16%, respectively; P < .0001). 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 disease-free survival. 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 (P = .0002). Similar results were seen for overall survival.

conclusionPNI 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.

Indexed as

AdenocarcinomaAdultAgedAged, 80 and overAntineoplastic AgentsChemotherapy, AdjuvantColorectal NeoplasmsCombined Modality TherapyDigestive System Surgical ProceduresDisease-Free SurvivalFemaleHumansKaplan-Meier EstimateMaleMiddle AgedNeoadjuvant TherapyAntineoplastic Agents

Identifiers

PMID19738119
PMCPMC2773472
OpenAlexW1974728334

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.