ArticleBMC cancer2023
Combining perineural invasion with staging improve the prognostic accuracy in colorectal cancer: a retrospective cohort study.
Article in BMC cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Prognostic and clinicopathological value of perineural invasion in colorectal cancer: a meta-analysis.Frontiers in oncology · 2026Pooled it
- Multiparametric MRI-based multi-channel deep learning model for accurate preoperative prediction of perineural invasion in lymph node-negative rectal cancer.Abdominal radiology (New York) · 2026Article
- The value of extracellular volume based on spectral CT in lymph node metastasis, perineural invasion, and lymphovascular invasion of colon cancer.Abdominal radiology (New York) · 2026Article
- Primary and secondary metastatic dissemination: multiple routes to cancer-related death.Molecular cancer · 2025Review
- Prognostic value of positive lymph node ratio, tumor deposit, and perineural invasion in advanced colorectal signet-ring cell carcinoma.Frontiers in molecular biosciences · 2025Article
- Identification of key genes associated with perineural invasion in stage II colorectal cancer and their prognostic implications.Frontiers in oncology · 2025Article
- Spectral CT in the evaluation of perineural invasion status in rectal cancer.Japanese journal of radiology · 2024Article
- The depth of perineural invasion is an independent prognostic factor for stage II colorectal cancer.BMC cancer · 2024Article
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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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