Related Experiment Video
Updated: Jun 12, 2025
A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma
Published on: January 5, 2017
Oncologic impact of perineural invasion in perihilar cholangiocarcinoma: an international multicenter study
Jun Kawashima1, Miho Akabane2, Diamantis I Tsilimigras2
1Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA; Department of Gastroenterological Surgery, Yokohama City University, School of Medicine, Yokohama, Japan.
Background:
We sought to evaluate the prognostic significance of perineural invasion (PNI) among patients undergoing curative-intent resection for perihilar cholangiocarcinoma (pCCA), with a specific focus on early-stage disease.
Methods:
Data from patients who underwent curative-intent resection for pCCA were collected from eight high-volume international hepatobiliary centers. The association between PNI status, clinicopathological features, and long-term survival was analyzed in both the overall cohort and a subset of patients with early-stage pCCA.
Results:
Among 435 patients, 364 (83.7 %) were PNI-positive. At the time of surgery, 53 patients with PNI underwent margin re-resection; only 19 (35.8 %) achieved a final R0 margin, whereas 34 (64.2 %) had a persistent R1 margin on the final pathological examination. PNI was independently associated with worse overall survival in the entire cohort (HR 1.52), as well as among patients with T1/2 (HR 1.53) and node-negative (HR 1.60) disease. Although not associated with improved survival among node-negative patients, adjuvant chemotherapy provided a survival benefit among patients with node-negative disease who had PNI (50.8 months vs. 28.6 months; p = 0.044).
Conclusion:
PNI was an independent predictor of long-term survival, particularly among patients with early-stage pCCA.
