Perineural invasion as a predictive factor for survival outcome in gastric cancer patients: a systematic review and meta-analysis. Issue 9 (24th January 2020)

• Record Type: Journal Article
• Authors: Zhao, Bochao; Lv, Wu; Mei, Di; Luo, Rui; Bao, Shiyang; Huang, Baojun; Lin, Jie
• Is Part Of: Journal of clinical pathology. Volume 73:Issue 9(2020)
• Page Start: 544
• Page End: 551
• Publication Date: 2020-01-24
• Subjects: gastric cancer -- perineural invasion -- survival -- prognostic factor; Pathology -- Periodicals; Pathology, Molecular -- Periodicals; 616.0705
• DOI: 10.1136/jclinpath-2019-206372
• Languages: English
• ISSNs: 0021-9746

Abstract

Abstract : Aims: The prognostic significance of perineural invasion (PNI) for gastric cancer (GC) patients was under debate. This study aimed to review relevant studies and evaluate the impact of PNI on the survival outcome of GC patients. Methods: Systematic literature search was performed using PubMed and Embase databases. The relevant data were extracted, and the association between PNI and clinicopathological characteristics or survival outcome in GC patients were evaluated using a fixed-effect model or random-effect model. Results: A total 13 studies involving 7004 GC patients were included in this meta-analysis. The positive rate of PNI was 35.9% (2512/7004) in GC patients, ranging from 6.9% to 75.6%. There were significant relationships between PNI and a series of unfavourable clinicopathological factors including undifferentiated histology type (OR: 1.78, 95% CI 1.37 to 2.33, p<0.001; I 2 =75.3%), diffuse type (OR: 1.96, 95% CI 1.07 to 3.60, p=0.029; I 2 =79.5%), lymphatic invasion (OR: 7.00, 95% CI 3.76 to 13.03, p<0.001; I 2 =83.6%), vascular invasion (OR: 5.79, 95% CI 1.59 to 21.13, p=0.008; I 2 =95.8%), deeper tumour invasion (OR: 4.79, 95% CI 3.65 to 6.28, p<0.001; I 2 =65.0%) and lymph node metastasis (OR: 3.60, 95% CI 2.37 to 5.47, p<0.001; I 2 =89.6%). In addition, PNI was significantly associated with worse survival outcome in GC patients (HR: 1.69, 95% CI 1.38 to 2.06, p<0.001; I 2 =71.0%). Conclusion: PNI was frequently detected in surgically resected specimens of GC patients, and it was a predictive factor for survival outcomes in these patients.