Sun Quanquan, Liu Tongxin, Liu Peng, Luo Jialin, Zhang Na, Lu Ke, Ju Haixing, Zhu Yuping, Wu Wei, Zhang Lingnan, Fan Yongtian, Liu Yong, Li Dechuan, Zhu Yuan, Liu Luying
Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, China.
Zhejiang Key Laboratory of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang Province, China.
J Cancer. 2019 May 21;10(10):2243-2249. doi: 10.7150/jca.31473. eCollection 2019.
: Perineural invasion (PNI) and lymphovascular invasion (LVI) are associated with poor prognosis in colorectal cancer, but their clinical significance is still controversial for patients with locally advanced rectal cancer (LARC) who had received neoadjuvant chemoradiotherapy (nCRT) and surgical resection. The aim of this study was to confirm the correlation between PNI and/or LVI and clinical prognosis and to further confirm whether PNI and/or LVI can be used as potential prognostic indicators of adjuvant chemotherapy after nCRT and surgery in LARC. : From February 2002 to December 2012, a total of 181 patients with LARC who had received nCRT and surgical resection were retrospectively reviewed. Overall survival (OS) and disease-free survival (DFS) were determined by the Kaplan-Meier method, log-rank test, and Cox proportional hazard regression model. : The median follow-up time was 48 months (range, 3 to 162 months). All the PNI-positive and/or LVI-positive patients showed adverse DFS and OS (<0.001). In multivariate analysis, PNI and LVI were independent prognostic factors for DFS. PNI, rather than LVI, was also an independent prognostic factor for OS. In a subgroup analysis, PNI-positive, rather than LVI-positive, may benefit from adjuvant chemotherapy. : For patients with LARC undergoing nCRT and surgery, PNI-positive and/or LVI positive were associated with poorer DFS and OS. And PNI-positive, rather than LVI-positive, may benefit from adjuvant chemotherapy.
神经周围侵犯（PNI）和淋巴管侵犯（LVI）与结直肠癌的预后不良相关，但对于接受新辅助放化疗（nCRT）和手术切除的局部晚期直肠癌（LARC）患者，它们的临床意义仍存在争议。本研究的目的是确认PNI和/或LVI与临床预后之间的相关性，并进一步确认PNI和/或LVI是否可作为LARC患者在nCRT和手术后辅助化疗的潜在预后指标。：回顾性分析了2002年2月至2012年12月期间共181例接受nCRT和手术切除的LARC患者。采用Kaplan-Meier法、对数秩检验和Cox比例风险回归模型确定总生存期（OS）和无病生存期（DFS）。：中位随访时间为48个月（范围3至162个月）。所有PNI阳性和/或LVI阳性患者的DFS和OS均较差（<0.001）。多因素分析中，PNI和LVI是DFS的独立预后因素。PNI而非LVI也是OS的独立预后因素。亚组分析中，PNI阳性而非LVI阳性患者可能从辅助化疗中获益。：对于接受nCRT和手术的LARC患者，PNI阳性和/或LVI阳性与较差的DFS和OS相关。且PNI阳性而非LVI阳性患者可能从辅助化疗中获益。
