A Study of Rectal Cancer with Perineural Invasion in Special Reference to Clinico-Pathological Factors

Yasushige Nagasawa, Kenzoh Yanagita, Kazuki Tsuzita, Tatsuo Yasushi, Tomohiko Gotoh, Toshiaki Kuwahara, Kaoru Andoh, Kimihiko Funahashi, Yoshifusa Torigoshi, Kiyoshi Watanabe, Hiroshi Nakamura, Hazime Kase, Miyoji Wakabayashi, Yoshihiko Okano, Kazuo Kobayashi, Tadahisa Ohgai, Shintaro Kuramoto, Toshifumi Yoshio, Shiroh Tsujimoto¹⁾

First Department of Surgery, Toho University School of Medicine
Second Department of Pathology, Toho University School of Medicine¹⁾

Rectal cancer of 218 patients were analyzed retrospectively for the relationship between nine factors and perineural invasion. The nine factors were age, sex, division of the rectum*, histological differentiation*, depth of invasion of the tumor*, lymphatic vessel invasion*, venous invasion*, lymph node metastasis* and Dukes' stage classification. Perineural invasion was found in 25.7% of all patients and had the closest statistical relationship to the following factors: depth of invasion of the tumor, lymph node metastasis, Dukes' classification, histological differentiation and venous invasion. Perineural invasion was not present in Dukes'A classification but existed in l3.7% of Dukes' B and in 44.6% of Dukes' C. The 5-year cumulative survival rate in Dukes' A cases was 92%. In Dukes' B cases with perineural invasion, the survival rate was 35.5% as opposed to 72% in those without perineural invasion. In Dukes' C cases, the survival rate was 10% as opposed to 37% in those without perineural invasion. Therefore, perineural invasion was regarded as one factor in prognosis and made worsened the rate of survival of patients with rectal cancer.
*Defined by Rules of Japanese Research Socity for Cancer of Colon and Rectum. (Jinnai: Jpn. J. Surg. 13: 557-598, 1983)

Key words
rectal cancer, neural invasion of rectal cancer, perineural invasion of rectal cancer, prognostic factor in rectal cancer

Reprint requests
Yasushige Nagasawa First Department of Surgery, Toho University School of Medicine
6-11-1 Oomorinishi, Oota-ku, Tokyo, 143 JAPAN

Accepted
December 12, 1990

To read the PDF file you will need Abobe Reader installed on your computer.