Perineural invasion score system and clinical outcomes in resected pancreatic cancer patients.

Autor: Nozzoli F; Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy. Electronic address: filippo.nozzoli@unifi.it., Catalano M; Section of Clinical Pharmacology & Oncology, Department of Health Sciences, University of Florence, Florence, Italy., Messerini L; Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy., Cianchi F; Section of Surgery, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Nassini R; Section of Clinical Pharmacology & Oncology, Department of Health Sciences, University of Florence, Florence, Italy., De Logu F; Section of Clinical Pharmacology & Oncology, Department of Health Sciences, University of Florence, Florence, Italy., Iannone LF; Section of Clinical Pharmacology & Oncology, Department of Health Sciences, University of Florence, Florence, Italy., Ugolini F; Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy., Simi S; Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy., Massi D; Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy., Geppetti P; Section of Clinical Pharmacology & Oncology, Department of Health Sciences, University of Florence, Florence, Italy., Roviello G; Section of Clinical Pharmacology & Oncology, Department of Health Sciences, University of Florence, Florence, Italy.
Jazyk: angličtina
Zdroj: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] [Pancreatology] 2024 Jun; Vol. 24 (4), pp. 553-561. Date of Electronic Publication: 2024 Mar 15.
DOI: 10.1016/j.pan.2024.03.004
Abstrakt: Background/objectives: Perineural invasion (PNI), classified according to its presence or absence in tumor specimens, is recognized as a poor prognostic factor in pancreatic ductal adenocarcinoma (PDAC) patients. Herein, we identified five histological features of PNI and investigated their impact on survival outcomes of PDAC resected patients.
Methods: Five histopathological features of PNI (diameter, number, site, sheath involvement, and mitotic figures within perineural invasion) were combined in an additional final score (ranging from 0 to 8), and clinical data of PDAC patients were retrospectively analyzed. PNI + patients were stratified in two categories according to the median score value (<6 and ≥ 6, respectively). Impact of PNI on disease-free survival (DFS) and overall survival (OS) were analyzed.
Results: Forty-five patients were enrolled, of whom 34 with PNI (PNI+) and 11 without PNI (PNI-). The DFS was 11 months vs. not reached (NR) (p = 0.258), while the OS was 19 months vs. NR (p = 0.040) in PNI+ and PNI- patients, respectively. A ≥6 PNI was identified as an independent predictor of worse OS vs. <6 PNI + patients (29 vs. 11 months, p < 0.001) and <6 PNI+ and PNI- patients (43 vs. 11 months, p < 0.001). PNI ≥6 was an independent negative prognostic factor of DFS vs. <6 PNI+ and PNI- patients (13 vs. 6 months, p = 0.022).
Conclusions: We report a PNI scoring system that stratifies surgically-treated PDAC patients in a graded manner that correlates with patient prognosis better than the current dichotomous (presence/absence) definition. However, further and larger studies are needed to support this PNI scoring system.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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