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Perineural Invasion Points to Colorectal Cancer Outcomes

Patients with PNI-negative tumors had higher rates of five-year disease-free, overall survival

FRIDAY, Sept. 11 (HealthDay News) -- Perineural invasion (PNI) is often not included in pathology reports for colorectal cancer, but it may serve as a predictor of outcomes in these cases, according to research published online Sept. 8 in the Journal of Clinical Oncology.

Catherine Liebig, M.D., of the Baylor College of Medicine in Houston, and colleagues analyzed data from 269 patients who underwent surgical resection of colorectal adenocarcinomas. Researchers reviewed the outcomes over a mean 6.8 years of follow-up and tumor samples were rechecked for PNI.

Although PNI was identified in less than 0.5 percent of original pathology reports, the new review found that 22 percent of tumors were PNI positive. Patients with PNI-negative tumors had a four-fold higher five-year disease-free survival rate, and a three-fold increase in overall survival.

"We believe that PNI status should become standard in pathology reports for colorectal tumors," the authors write. "In conclusion, PNI is an under-reported phenomenon in colorectal cancer. Our data strongly suggest that PNI could function as an independent prognostic factor of outcomes in colorectal cancer and support consideration of PNI status in primary colorectal cancer specimens for therapy stratification. In particular, we advocate consideration of node-negative patients who are PNI positive for treatment with currently available effective adjuvant therapies."

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