The role of perineural invasion in predicting survival in patients with primary operable colorectal cancer: a systematic review

Van Wyk, H. , Going, J., Horgan, P. and McMillan, D. C. (2017) The role of perineural invasion in predicting survival in patients with primary operable colorectal cancer: a systematic review. Critical Reviews in Oncology/Hematology, 112, pp. 11-20. (doi:10.1016/j.critrevonc.2017.02.005) (PMID:28325252)

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Abstract

Perineural invasion is a clear route for cancer cell spread however, the role of nerves in cancer progression is relatively unknown. Recent work would suggest that nerves can actively infiltrate the tumour microenvironment and stimulate cancer cell growth. Therefore, the aim of the present study was to systematically review the identification and associations of perineural invasion and survival in patients with primary operable colorectal cancer. From initial search results of 912 articles, 38 studies were selected. Using H&E stains; five studies including 1835 patients reported on survival stratified by perineural invasion in colon cancer with weighted average detection rates of 26%; eleven studies including 3837 patients reported on rectal cancer with weighted average detection rates of 25% and; sixteen studies including 9145 patients reported on survival stratified by perineural invasion in colorectal cancer with weighted average detection rates of 17%. Using special techniques (S100), six studies including 1458 patients reported on the identification of perineural invasion in colorectal cancer. In comparison to H&E staining alone, the use of immunohistochemistry with S100 increased the detection of perineural invasion to approximately 70%. However, those studies did not examine the relationship with outcomes, so further research is required to establish the clinical significance of perineural invasion detected by immunohistochemistry. In conclusion, perineural invasion deserves special attention for improved prognostic stratification in patients with colorectal cancer. Further work is required to standardise pathology assessment and reporting of perineural invasion, in particular its definition, use of special stains and routine inclusion in pathology practice. Reliable assessment is required for investigations into mechanisms of perineural invasion, its role tumour spread and prognostic value.

Item Type:Articles
Keywords:Colorectal cancer, perineural invasion, prognosis, survival.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Horgan, Professor Paul and McMillan, Professor Donald and Going, Dr James and Van Wyk, Dr Hester
Authors: Van Wyk, H., Going, J., Horgan, P., and McMillan, D. C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Critical Reviews in Oncology/Hematology
Publisher:Elsevier
ISSN:1040-8428
ISSN (Online):1879-0461
Published Online:07 February 2017
Copyright Holders:Copyright © 2017 Elsevier B.V.
First Published:First published in Critical Reviews in Oncology/Hematology 112:11-20
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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