Perineural Invasion is a Strong Prognostic Moderator in Ampulla of Vater Carcinoma: A Meta-analysis

Claudio Luchini, Nicola Veronese, Alessia Nottegar, Giulio Riva, Camilla Pilati, Andrea Mafficini, Brendon Stubbs, Michele Simbolo, Aldo Mombello, Vincenzo Corbo, Liang Cheng, Shinichi Yachida, Laura Delong Wood, Rita T. Lawlor, Roberto Salvia, Aldo Scarpa

Research output: Contribution to journalArticle

Abstract

Objective Ampulla of Vater carcinoma (AVC) has a broad spectrum of different prognoses. As such, new moderators of survival are urgently needed. We aimed at clarifying the prognostic role of perineural invasion in AVC. Methods Using PubMed and SCOPUS databases, we conducted the first systematic review and meta-analysis on this topic. Results Analyzing 29 articles for a total of 2379 patients, we found that the presence of perineural invasion increased the risk of all-cause mortality more than 2 times (relative risk [RR], 2.07; 95% confidence interval [CI], 1.78-2.42 [P < 0.0001]; hazard ratio [HR], 2.72; 95% CI, 1.86-3.97 [P < 0.0001]), of cancer-specific mortality more than 6 times (RR, 6.12; 95% CI, 3.25-11.54 [P < 0.0001]; HR, 6.59; 95% CI, 2.29-3.49 [P < 0.0001]), and of recurrence more than 2 times (RR, 2.63; 95% CI, 1.89-3.67 [P < 0.0001]; HR, 2.54; 95% CI, 1.24-5.21 [P = 0.01]). Conclusions Perineural invasion is strongly associated with a poorer prognosis in AVC, influencing both survival and risk of recurrence. It should be reported in the final pathology report and should be taken into account by future oncologic staging systems, identifying a group of AVC with a more malignant biological behavior.

Original languageEnglish (US)
Pages (from-to)70-76
Number of pages7
JournalPancreas
Volume48
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Ampulla of Vater
Meta-Analysis
Confidence Intervals
Carcinoma
Recurrence
Survival
Mortality
PubMed
Databases
Pathology
Neoplasms

Keywords

  • papilla
  • perineural
  • PNI
  • Vater

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

Cite this

Luchini, C., Veronese, N., Nottegar, A., Riva, G., Pilati, C., Mafficini, A., ... Scarpa, A. (2019). Perineural Invasion is a Strong Prognostic Moderator in Ampulla of Vater Carcinoma: A Meta-analysis. Pancreas, 48(1), 70-76. https://doi.org/10.1097/MPA.0000000000001194

Perineural Invasion is a Strong Prognostic Moderator in Ampulla of Vater Carcinoma : A Meta-analysis. / Luchini, Claudio; Veronese, Nicola; Nottegar, Alessia; Riva, Giulio; Pilati, Camilla; Mafficini, Andrea; Stubbs, Brendon; Simbolo, Michele; Mombello, Aldo; Corbo, Vincenzo; Cheng, Liang; Yachida, Shinichi; Wood, Laura Delong; Lawlor, Rita T.; Salvia, Roberto; Scarpa, Aldo.

In: Pancreas, Vol. 48, No. 1, 01.01.2019, p. 70-76.

Research output: Contribution to journalArticle

Luchini, C, Veronese, N, Nottegar, A, Riva, G, Pilati, C, Mafficini, A, Stubbs, B, Simbolo, M, Mombello, A, Corbo, V, Cheng, L, Yachida, S, Wood, LD, Lawlor, RT, Salvia, R & Scarpa, A 2019, 'Perineural Invasion is a Strong Prognostic Moderator in Ampulla of Vater Carcinoma: A Meta-analysis' Pancreas, vol. 48, no. 1, pp. 70-76. https://doi.org/10.1097/MPA.0000000000001194
Luchini, Claudio ; Veronese, Nicola ; Nottegar, Alessia ; Riva, Giulio ; Pilati, Camilla ; Mafficini, Andrea ; Stubbs, Brendon ; Simbolo, Michele ; Mombello, Aldo ; Corbo, Vincenzo ; Cheng, Liang ; Yachida, Shinichi ; Wood, Laura Delong ; Lawlor, Rita T. ; Salvia, Roberto ; Scarpa, Aldo. / Perineural Invasion is a Strong Prognostic Moderator in Ampulla of Vater Carcinoma : A Meta-analysis. In: Pancreas. 2019 ; Vol. 48, No. 1. pp. 70-76.
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abstract = "Objective Ampulla of Vater carcinoma (AVC) has a broad spectrum of different prognoses. As such, new moderators of survival are urgently needed. We aimed at clarifying the prognostic role of perineural invasion in AVC. Methods Using PubMed and SCOPUS databases, we conducted the first systematic review and meta-analysis on this topic. Results Analyzing 29 articles for a total of 2379 patients, we found that the presence of perineural invasion increased the risk of all-cause mortality more than 2 times (relative risk [RR], 2.07; 95{\%} confidence interval [CI], 1.78-2.42 [P < 0.0001]; hazard ratio [HR], 2.72; 95{\%} CI, 1.86-3.97 [P < 0.0001]), of cancer-specific mortality more than 6 times (RR, 6.12; 95{\%} CI, 3.25-11.54 [P < 0.0001]; HR, 6.59; 95{\%} CI, 2.29-3.49 [P < 0.0001]), and of recurrence more than 2 times (RR, 2.63; 95{\%} CI, 1.89-3.67 [P < 0.0001]; HR, 2.54; 95{\%} CI, 1.24-5.21 [P = 0.01]). Conclusions Perineural invasion is strongly associated with a poorer prognosis in AVC, influencing both survival and risk of recurrence. It should be reported in the final pathology report and should be taken into account by future oncologic staging systems, identifying a group of AVC with a more malignant biological behavior.",
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T2 - A Meta-analysis

AU - Luchini, Claudio

AU - Veronese, Nicola

AU - Nottegar, Alessia

AU - Riva, Giulio

AU - Pilati, Camilla

AU - Mafficini, Andrea

AU - Stubbs, Brendon

AU - Simbolo, Michele

AU - Mombello, Aldo

AU - Corbo, Vincenzo

AU - Cheng, Liang

AU - Yachida, Shinichi

AU - Wood, Laura Delong

AU - Lawlor, Rita T.

AU - Salvia, Roberto

AU - Scarpa, Aldo

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective Ampulla of Vater carcinoma (AVC) has a broad spectrum of different prognoses. As such, new moderators of survival are urgently needed. We aimed at clarifying the prognostic role of perineural invasion in AVC. Methods Using PubMed and SCOPUS databases, we conducted the first systematic review and meta-analysis on this topic. Results Analyzing 29 articles for a total of 2379 patients, we found that the presence of perineural invasion increased the risk of all-cause mortality more than 2 times (relative risk [RR], 2.07; 95% confidence interval [CI], 1.78-2.42 [P < 0.0001]; hazard ratio [HR], 2.72; 95% CI, 1.86-3.97 [P < 0.0001]), of cancer-specific mortality more than 6 times (RR, 6.12; 95% CI, 3.25-11.54 [P < 0.0001]; HR, 6.59; 95% CI, 2.29-3.49 [P < 0.0001]), and of recurrence more than 2 times (RR, 2.63; 95% CI, 1.89-3.67 [P < 0.0001]; HR, 2.54; 95% CI, 1.24-5.21 [P = 0.01]). Conclusions Perineural invasion is strongly associated with a poorer prognosis in AVC, influencing both survival and risk of recurrence. It should be reported in the final pathology report and should be taken into account by future oncologic staging systems, identifying a group of AVC with a more malignant biological behavior.

AB - Objective Ampulla of Vater carcinoma (AVC) has a broad spectrum of different prognoses. As such, new moderators of survival are urgently needed. We aimed at clarifying the prognostic role of perineural invasion in AVC. Methods Using PubMed and SCOPUS databases, we conducted the first systematic review and meta-analysis on this topic. Results Analyzing 29 articles for a total of 2379 patients, we found that the presence of perineural invasion increased the risk of all-cause mortality more than 2 times (relative risk [RR], 2.07; 95% confidence interval [CI], 1.78-2.42 [P < 0.0001]; hazard ratio [HR], 2.72; 95% CI, 1.86-3.97 [P < 0.0001]), of cancer-specific mortality more than 6 times (RR, 6.12; 95% CI, 3.25-11.54 [P < 0.0001]; HR, 6.59; 95% CI, 2.29-3.49 [P < 0.0001]), and of recurrence more than 2 times (RR, 2.63; 95% CI, 1.89-3.67 [P < 0.0001]; HR, 2.54; 95% CI, 1.24-5.21 [P = 0.01]). Conclusions Perineural invasion is strongly associated with a poorer prognosis in AVC, influencing both survival and risk of recurrence. It should be reported in the final pathology report and should be taken into account by future oncologic staging systems, identifying a group of AVC with a more malignant biological behavior.

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