Erschienen in:
01.06.2015 | Original Article
Prognostic Value of Perineural Invasion in Colorectal Cancer: A Meta-Analysis
verfasst von:
Yuchong Yang, Xuanzhang Huang, Jingxu Sun, Peng Gao, Yongxi Song, Xiaowan Chen, Junhua Zhao, Zhenning Wang
Erschienen in:
Journal of Gastrointestinal Surgery
|
Ausgabe 6/2015
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Abstract
Background
The prognostic value of perineural invasion (PNI) in colorectal cancer (CRC) does not reach a consensus.
Methods
A comprehensive literature search for relevant reports published up to October 2014 was performed using the electronic databases: PubMed, Embase, and Web of Science. The pooled hazard ratio (HR) with 95 % confidence intervals (CI) was used to estimate the prognostic effects.
Result
Thirty-eight studies comprising 12,661 CRC patients were analyzed. Our results showed that PNI is significantly associated with poor prognosis in OS (overall survival) (HR = 2.07, 95 % CI = 1.87–2.29, P < 0.01) and DFS (disease-free survival) (HR = 2.23, 95 % CI = 1.79–2.78, P < 0.01). There was no significant prognostic difference in DFS between stage II CRC patients with PNI(+) and stage III patients (HR = 1.67, 95 % CI = 0.53–5.25, P = 0.38). Further subgroup analysis revealed that the significance of the association between PNI and worse prognosis in CRC patients is not affected by many factors, including geographic setting, PNI positive rate, treatment, TNM stage, tumor site, and quality of the study.
Conclusions
The meta-analysis indicates that PNI is a poor prognostic factor in CRC patients. The postoperative survival of stage II CRC patients with PNI(+) is probably more similar to that of stage III patients. Currently available adjuvant therapy should be considered in stage II CRC patients with PNI(+).