Prognostic Value of Lymphovascular and Perineural Invasion in Colon Cancer

INTRODUCTION: Colon cancer is one of the most common types of malignant tumours in the world. Colon cancer ranks fourth among cancer-related deaths. Lymphovascular invasion (LVI) is the tumour involvement of small lymphatic or blood (typically venous) vessels while perineural invasion (PNI) is the growth of the tumour in, around, and along the nerves and nerve sheaths. In our study, we investigated the effects of LVI and PNI on prognosis, tumour stages, and lymph node metastasis in colon cancer patients.
METHODS: The data of patients, who underwent colon cancer surgery in the period between February 2013 and January 2020, were analyzed retrospectively. The surgery and pathology reports, demographic characteristics, and overall survival of the patients were examined.
RESULTS: A total of 248 patients were operated due to colon cancer. LVI and PNI were present in 120 (48.3%) and 105 (41.9%) patients, respectively. The relationship of the grade, of the presence of positive lymph nodes, LVI, and PNI, and of the T- and N-stages with the survival were statistically significant with the following p-values of 0.028, <0.001, <0.001, <0.001, 0.005, and <0.001, respectively. When the relationship of LVI and PNI with other factors was examined, it was shown that there was a statistically significant relationship in both groups in terms of T and N stage, metastatic lymph node and survival time. (p <0.001)
DISCUSSION AND CONCLUSION: Because the presence of LVI and PNI is a determinant of prognosis and lymph node metastasis especially in early-stage patients; we think that close follow-up of patients with LVI and PNI and the evaluation of such patients by a multidisciplinary council for the administration of adjuvant therapy, may affect prognosis favourably.

Kolon Kanserinde Lenfovaskuler ve Perinoral Invazyonun Prognostik Onemi

GÝRÝÞ ve AMAÇ: Kolon kanseri tüm dünyada en sýk görülen maligniteler arasýndadýr. Kansere baðlý ölüm nedenleri arasýnda 4. Sýradadýr. Lenfovasküler invazyon (LVI), küçük lenfatik veya kan (tipik olarak venöz) damarlarýn tümör tarafýndan tutulmasý iken perinöral invazyon (PNI) ise sinirlerin ve sinir kýlýflarýnýn içinde, çevresinde ve boyunca tümörün büyümesidir. Çalýþmamýzda LVI ve PNI’nýn kolon kanserli hastalarda prognoz, tümör evresi ve lenf nodu metastazýna etkisi araþtýrdýk.
YÖNTEM ve GEREÇLER: Þubat 2013 - Ocak 2020 tarihleri arasýnda kolon kanseri nedeniyle opere edilen hastalarýn verileri retrospektif olarak inceledi. Hastalarýn ameliyat ve patoloji raporlarý, demografik özellikleri, genel saðkalýmlarý incelendi.
BULGULAR: 248 hasta kolon kanseri nedeniyle opere edildi. 120 hastada LVI, 105 (41.9%) PNI hastada vardý. Grade, lenf nodu pozitifliði, LVI, PNI, T ve N evrelerinin saðkalýmla iliþkisi istatistiksel olarak anlamlý bulunmuþ olup sýrasýyla p deðerleri: 0.028, <0.001, <0.001, <0.001, 0.005 ve <0.001’dir. LVI ve PNI'nin diðer faktörlerle iliþkisi incelendiðinde, T ve N evresi, metastatik lenf nodu ve saðkalým süresi açýsýndan her iki grupta da istatistiksel olarak anlamlý bir iliþki olduðu gösterilmiþtir. (p <0,001)
TARTIÞMA ve SONUÇ: LVI ve PNI varlýðý özellikle erken evre hastalarda prognozun, lenf nodu metastazýnýn bir belirleyici olmasýndan dolayý; LVI ve PNI pozitif olan hastalarýn yakýn izlemin, adjuvan tedavi için multidisipliner konseyde deðerlendirilmenin prognoza olumlu etkilerinin olabileceðini düþünmekteyiz.