Prognostic impact of perineural invasion in intrahepatic cholangiocarcinoma: multicentre study
Prognostic impact of perineural invasion in intrahepatic cholangiocarcinoma: multicentre study
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DOI：
10.1093/bjs/znac098
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发表时间：
2022-05-03
影响因子：
9.6
通讯作者：
Pawlik, Timothy M.
中科院分区：
文献类型：
--
作者：
Wei, Tao;Zhang, Xu-Feng;Pawlik, Timothy M.
在1095例接受ICC切除术的患者中，239例（21.8%）存在PNI。PNI的存在与更差的无病生存期以及总生存期相关;特别是在AJCC T1-2（981例患者）或N 0（249例）疾病中，PNI仍然与更差的DFS相关。PNI是一个强大的独立预测肿瘤复发和长期生存切除术后的治愈意图，即使在患者早期diseases.Background的目的，本研究的目的是调查的预后影响神经浸润（PNI）对肿瘤复发和生存切除肝内胆管癌（ICC）患者。方法这是一项多中心、回顾性研究，研究对象为2000年至2017年间因ICC接受根治性切除术的患者。在整个队列和早期ICC患者亚组中分析PNI、临床病理特征和长期生存率之间的关系。结果在1095例接受ICC切除术的患者中，239例（21.8%）存在PNI。在单变量分析中，PNI与更差的无病生存期（DFS）（有PNI和无PNI患者的中位数分别为13.2和16.1个月; P = 0.038）和总生存期（OS）（26.4和41.5个月; P < 0.001）相关。在多变量分析中，PNI是与DFS降低相关的独立风险因素（风险比（HR）1.56，95%置信区间）。1.06至2.13; P = 0.019）和OS（HR 1.74，1.16至2.60; P = 0.007）。在早期疾病患者的亚组分析中（AJCC T1-2，981例患者;或N 0，249例患者），PNI仍与DFS恶化相关（T1-2：伴和不伴PNI患者的中位时间分别为13.7和16.6个月，P = 0.019; N 0：11.7和17.5个月，P = 0.022）和OS（T1-2：28.5 vs 45.7个月，P < 0.001; N 0：34.9 vs 47.5个月，P = 0.036）。结论PNI是一个强有力的独立预测肿瘤复发和长期生存的ICC切除术后的根治性意图，即使在早期疾病的患者。应定期评估PNI的存在。
Among 1095 patients who underwent resection of ICC, PNI was present in 239 (21.8 per cent). The presence of PNI was associated with worse disease-free survival, as well as overall survival; especially among those with AJCC T1-2 (981 patients) or N0 (249) disease, PNI remained associated with worse DFS. PNI was a strong independent predictor of tumour recurrence and long-term survival after resection with curative intent, even among patients early-stage disease.Background The aim of this study was to investigate the prognostic impact of perineural invasion (PNI) on tumour recurrence and survival among patients with resected intrahepatic cholangiocarcinoma (ICC). Methods This was a multicentre, retrospective study of patients who underwent resection with curative intent for ICC between 2000 and 2017. The relationship between PNI, clinicopathological characteristics, and long-term survival was analysed in the overall cohort and the subset of patients with early-stage ICC. Results Among 1095 patients who underwent resection of ICC, PNI was present in 239 (21.8 per cent). In univariable analysis, PNI was associated with worse disease-free survival (DFS) (median 13.2 versus 16.1 months for patients with and without PNI respectively; P = 0.038) and overall survival (OS) (26.4 versus 41.5 months; P < 0.001). In multivariable analysis, PNI was an independent risk factor associated with reduced DFS (hazard ratio (HR) 1.56, 95 per cent c.i. 1.06 to 2.13; P = 0.019) and OS (HR 1.74, 1.16 to 2.60; P = 0.007). In subgroup analysis of patients with early-stage disease (AJCC T1-2, 981 patients; or N0, 249 patients), PNI remained associated with worse DFS (T1-2: median 13.7 versus 16.6 months in patients with and without PNI respectively, P = 0.019; N0: 11.7 versus 17.5 months, P = 0.022) and OS (T1-2: 28.5 versus 45.7 months, P < 0.001; N0: 34.9 versus 47.5 months, P = 0.036). Conclusion PNI is a strong independent predictor of tumour recurrence and long-term survival following resection of ICC with curative intent, even among patients with early-stage disease. The presence of PNI should be assessed routinely.