[Local spread of carcinoma of the esophagus by perineural invasion]

For clarification of the clinico-pathological features of carcinoma of the esophagus by perineural invasion (pni), 107 resected specimens were histologically examined. A correlation between pni and other findings, including clinical results, was sought. Pni was found in 31 patients (29.0%). It was found in no cases without adventitial cancerous invasion, at 26.3% in a1, 36.5% in a2 and 66.7% in a3. Pni would thus appear to be closely correlated with the depth of invasion. It also showed correlation with lymph-canal invasion but not with venous invasion or lymph node metastasis. Pni positivity was the same regardless of patient's age and sex, as well as tumor size, location and histological differentiation. In patients who had undergone preoperative radiotherapy, lymph-canal and venous invasion were noted to have markedly decreased but not pni. Curative resection was carried out in 57.9% of the pni negative patients and in 32.3% of the pni positive. Local recurrence was observed in 30.0% of pni positive and only 4.5% of negative cases. The cumulative survival rate was not significantly less in positive compared to negative patients.