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Perineural and intraneural invasion in posttherapy pancreaticoduodenectomy specimens predicts poor prognosis in patients with pancreatic ductal adenocarcinoma.

Publication ,  Journal Article
Chatterjee, D; Katz, MH; Rashid, A; Wang, H; Iuga, AC; Varadhachary, GR; Wolff, RA; Lee, JE; Pisters, PW; Crane, CH; Gomez, HF; Abbruzzese, JL ...
Published in: Am J Surg Pathol
March 2012

Perineural invasion (PNI) is one of the established prognostic factors in pancreatic ductal adenocarcinoma (PDAC). However, the prognostic significance of PNI in patients with PDAC who received neoadjuvant therapy and pancreaticoduodenectomy is not clear. In this study, we performed a detailed examination of neural invasion in pancreaticoduodenectomy specimens from 212 patients with PDAC who received neoadjuvant chemoradiation (treated group) and in 60 untreated patients at our institution between January 1999 and December 2007. The frequency of PNI was higher in the untreated group (80%, 48/60) than in the treated group (58%, 123/212). For the 123 treated cases that were positive for PNI, extratumoral PNI, intratumoral PNI, intrapancreatic PNI only, extrapancreatic PNI, and intraneural invasion were identified in 86 (69.9%), 37 (30.1%), 11 (8.9%), 112 (91.1%), and 35 cases (28.5%), respectively. The presence of PNI correlated with tumor size, margin status, lymph node metastasis, pathologic tumor, and American Joint Committee on Cancer stages in the treated group. Tumor involvement of nerves >0.8 mm correlated with higher frequency of positive margin compared with tumors with PNI involving nerves ≤0.8 mm but not with other clinicopathologic parameters and survival. In the treated group, the presence of PNI or intraneural invasion correlated significantly with shorter disease-free survival and overall survival compared with no PNI or PNI only, respectively. PNI was an independent prognostic factor for both disease-free survival and overall survival in multivariate analysis. Our results showed that PNI plays an important role in the progression of PDAC and in predicting prognosis in this group of patients.

Duke Scholars

Published In

Am J Surg Pathol

DOI

EISSN

1532-0979

Publication Date

March 2012

Volume

36

Issue

3

Start / End Page

409 / 417

Location

United States

Related Subject Headings

  • Tumor Burden
  • Treatment Outcome
  • Time Factors
  • Survival Rate
  • Risk Factors
  • Risk Assessment
  • Proportional Hazards Models
  • Pathology
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms
 

Citation

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Chatterjee, D., Katz, M. H., Rashid, A., Wang, H., Iuga, A. C., Varadhachary, G. R., … Fleming, J. B. (2012). Perineural and intraneural invasion in posttherapy pancreaticoduodenectomy specimens predicts poor prognosis in patients with pancreatic ductal adenocarcinoma. Am J Surg Pathol, 36(3), 409–417. https://doi.org/10.1097/PAS.0b013e31824104c5
Chatterjee, Deyali, Matthew H. Katz, Asif Rashid, Hua Wang, Alina C. Iuga, Gauri R. Varadhachary, Robert A. Wolff, et al. “Perineural and intraneural invasion in posttherapy pancreaticoduodenectomy specimens predicts poor prognosis in patients with pancreatic ductal adenocarcinoma.Am J Surg Pathol 36, no. 3 (March 2012): 409–17. https://doi.org/10.1097/PAS.0b013e31824104c5.
Chatterjee D, Katz MH, Rashid A, Wang H, Iuga AC, Varadhachary GR, et al. Perineural and intraneural invasion in posttherapy pancreaticoduodenectomy specimens predicts poor prognosis in patients with pancreatic ductal adenocarcinoma. Am J Surg Pathol. 2012 Mar;36(3):409–17.
Chatterjee, Deyali, et al. “Perineural and intraneural invasion in posttherapy pancreaticoduodenectomy specimens predicts poor prognosis in patients with pancreatic ductal adenocarcinoma.Am J Surg Pathol, vol. 36, no. 3, Mar. 2012, pp. 409–17. Pubmed, doi:10.1097/PAS.0b013e31824104c5.
Chatterjee D, Katz MH, Rashid A, Wang H, Iuga AC, Varadhachary GR, Wolff RA, Lee JE, Pisters PW, Crane CH, Gomez HF, Abbruzzese JL, Fleming JB. Perineural and intraneural invasion in posttherapy pancreaticoduodenectomy specimens predicts poor prognosis in patients with pancreatic ductal adenocarcinoma. Am J Surg Pathol. 2012 Mar;36(3):409–417.

Published In

Am J Surg Pathol

DOI

EISSN

1532-0979

Publication Date

March 2012

Volume

36

Issue

3

Start / End Page

409 / 417

Location

United States

Related Subject Headings

  • Tumor Burden
  • Treatment Outcome
  • Time Factors
  • Survival Rate
  • Risk Factors
  • Risk Assessment
  • Proportional Hazards Models
  • Pathology
  • Pancreaticoduodenectomy
  • Pancreatic Neoplasms