Impact of perineural invasion on survival in node negative colon cancer

Katelin A. Mirkin, Christopher S. Hollenbeak, Ali Mohamed, Yuxia Jia, Wafik S. El-Deiry, Evangelos Messaris

Research output: Contribution to journalArticle

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Abstract

Perineural invasion (PNI) has been implicated as a poor prognostic indicator in many cancers. The National Comprehensive Cancer Network recommends consideration of observation or adjuvant therapy in the presence of PNI in early colon cancer. These recommendations are based on single institutional studies that fail to evaluate PNI within the context of adjuvant chemotherapy. The US National Cancer Database (2004–2012) was reviewed for patients with node negative colon cancer, and stratified by PNI and receipt of chemotherapy. Of 21,488 patients evaluated, 55.2% had T3 disease (n = 11,852), 23.1% had T2 (n = 4,971), 14.4% had T1 (n = 3,088), and 7.3% had T4 disease (n = 1,577); 4.6% (n = 987) had PNI. Most patients (86.8%, n = 18,641) did not have PNI and did not receive chemotherapy; 8.7% (n = 1,860) did not have PNI but received chemotherapy; 3.7% (n = 785) had PNI and did not receive chemotherapy, and 0.9% (n = 202) had PNI and received chemotherapy. Among those with PNI, patients who received chemotherapy tended to be younger (P<0.001), covered by private insurance (P<0.001), with fewer comorbidities (P<0.001), and greater T stage disease (P<0.001). Those with PNI who received chemotherapy had significantly improved survival over those who did not in T3–4 disease (P<0.001), but not in T1–2 disease. On multivariate analysis, those with PNI had a 38% greater hazard of mortality (HR 1.38, P<0.001). Additionally, chemotherapy decreased the hazard of mortality by 43% (HR 0.57, P<0.001). PNI appears to be an independent poor prognostic indicator in stage T3–4 node negative colon cancer. Chemotherapy administered to this patient population is associated with improved survival.

Original languageEnglish (US)
Pages (from-to)740-745
Number of pages6
JournalCancer Biology and Therapy
Volume18
Issue number9
DOIs
StatePublished - Sep 2 2017

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Colonic Neoplasms
Drug Therapy
Survival
Neoplasms
Mortality
Adjuvant Chemotherapy
Insurance
Comorbidity
Multivariate Analysis
Observation
Databases
Population

All Science Journal Classification (ASJC) codes

  • Molecular Medicine
  • Oncology
  • Pharmacology
  • Cancer Research

Cite this

Mirkin, Katelin A. ; Hollenbeak, Christopher S. ; Mohamed, Ali ; Jia, Yuxia ; El-Deiry, Wafik S. ; Messaris, Evangelos. / Impact of perineural invasion on survival in node negative colon cancer. In: Cancer Biology and Therapy. 2017 ; Vol. 18, No. 9. pp. 740-745.
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abstract = "Perineural invasion (PNI) has been implicated as a poor prognostic indicator in many cancers. The National Comprehensive Cancer Network recommends consideration of observation or adjuvant therapy in the presence of PNI in early colon cancer. These recommendations are based on single institutional studies that fail to evaluate PNI within the context of adjuvant chemotherapy. The US National Cancer Database (2004–2012) was reviewed for patients with node negative colon cancer, and stratified by PNI and receipt of chemotherapy. Of 21,488 patients evaluated, 55.2{\%} had T3 disease (n = 11,852), 23.1{\%} had T2 (n = 4,971), 14.4{\%} had T1 (n = 3,088), and 7.3{\%} had T4 disease (n = 1,577); 4.6{\%} (n = 987) had PNI. Most patients (86.8{\%}, n = 18,641) did not have PNI and did not receive chemotherapy; 8.7{\%} (n = 1,860) did not have PNI but received chemotherapy; 3.7{\%} (n = 785) had PNI and did not receive chemotherapy, and 0.9{\%} (n = 202) had PNI and received chemotherapy. Among those with PNI, patients who received chemotherapy tended to be younger (P<0.001), covered by private insurance (P<0.001), with fewer comorbidities (P<0.001), and greater T stage disease (P<0.001). Those with PNI who received chemotherapy had significantly improved survival over those who did not in T3–4 disease (P<0.001), but not in T1–2 disease. On multivariate analysis, those with PNI had a 38{\%} greater hazard of mortality (HR 1.38, P<0.001). Additionally, chemotherapy decreased the hazard of mortality by 43{\%} (HR 0.57, P<0.001). PNI appears to be an independent poor prognostic indicator in stage T3–4 node negative colon cancer. Chemotherapy administered to this patient population is associated with improved survival.",
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Impact of perineural invasion on survival in node negative colon cancer. / Mirkin, Katelin A.; Hollenbeak, Christopher S.; Mohamed, Ali; Jia, Yuxia; El-Deiry, Wafik S.; Messaris, Evangelos.

In: Cancer Biology and Therapy, Vol. 18, No. 9, 02.09.2017, p. 740-745.

Research output: Contribution to journalArticle

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AU - Mirkin, Katelin A.

AU - Hollenbeak, Christopher S.

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