OBJECTIVES: The benefit of adjuvant chemotherapy in @entity1 with locally advanced @entity5 (LARC) treated with neoadjuvant chemoradiotherapy (nCRT) and surgery is controversial. We examined the association of perineural invasion (PNI) with outcomes to determine whether PNI could be used to risk-stratify @entity1 . MATERIALS AND METHODS: We performed a retrospective study of 110 @entity1 treated with nCRT and surgery for LARC at our institution from 2004 to 2011. Eighty-seven @entity1 were identified in our final analysis. We evaluated the association of PNI with locoregional control, distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival, using log-rank and Cox proportional hazard modeling. RESULTS: Fourteen @entity1 (16%) were PNI+ and 73 @entity1 (84%) were PNI-. The median follow-up was 27 months (range, 0.9 to 84 mo). The median DMFS was 13.5 months for PNI+ and median not reached (>40 mo) for PNI- (P<0.0001). The median DFS was 13.5 months for PNI+ and 39.8 months for PNI- (P<0.0001). In a multivariate model including 7 pathologic variables, type of surgery, time to surgery from end of nCRT, and use of adjuvant chemotherapy, PNI remained a significant independent predictor of DMFS (hazard ratio 9.79; 95% confidence interval, 3.48-27.53; P<0.0001) and DFS (hazard ratio 5.72; 95% confidence interval, 2.2-14.9; P=0.0001). CONCLUSIONS: For @entity1 with LARC treated with nCRT, PNI found at the time of surgery is significantly associated with worse DMFS and DFS. Our data support testing the role of adjuvant chemotherapy in @entity1 with PNI and perhaps other high-risk features.

Perineural Invasion Predicts for Distant Metastasis in Locally Advanced XXXX and Surgery.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['rectal cancer']
@entity5 :: (MESH:D009369,Disease) :: ['Rectal Cancer Treated With Neoadjuvant Chemoradiation']
