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Monday Poster Session

Category: Colon

P1180 - Is Perineural Invasion Associated With Poor Survival Among Patients With Colorectal Cancer? A Surveillance, Epidemiology and End-Results (SEER) Database Analysis

Monday, October 25, 2021

10:30 AM – 4:15 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

Usman Tariq, MD

Allegheny Health Network
Pittsburgh, PA, United States

Usman Tariq, MD¹, Azeem Malik, MD², Bandhul Hans, MD¹, Rahul Karna, MD¹, Heitham Abdul-Baki, MD¹
¹Allegheny Health Network, Pittsburgh, PA; ²The Ohio State University Wexner Medical Center, Columbus, OH

Introduction: Historically, the prognosis of colorectal cancer was determined using conventional staging techniques including tumor size, nodal involvement, and distant metastases. According to literature, the utility of perineural involvement as an indicator for disease severity and therefore prognostic indication at the time diagnosis is limited. We aim to utilize a national cancer registry, the SEER database, to determine if the presence of perineural involvement is associated with an overall poor prognosis and long-term survival.

Methods: The 2004 to 2017 Surveillance, Epidemiology and End-Results (SEER) database was queried using International Classification
of Diseases Oncology 3rd Edition (ICD-O-3) codes to identify patients with colorectal cancers. The Collaborative Staging Site-Specific Factor 8 was used to identify whether patients had presence of perineural invasion. Kaplan Meier 5-year survival analyses was used to report differences in 5-year survival rates for those individuals who had presence of perineural invasion or not. Multivariate cox regression analyses was used to assess whether presence of perineural invasion was associated with poor overall survival.

Results: A total of 6,269 patients (11.0%) had presence of perineural invasion. The 5-year unadjusted survival rate for patients without perineural was 65.3% compared to 40.6% in patients with perineural involvement (Figure 1). After adjusting for baseline demographics and tumor characteristics via a Cox regression analysis, perineural involvement remained significantly associated with poor disease-specific survival (HR, 1.55; 95% CI, 1.48-1.62; p-value < 0.001) (Table 1).

Discussion: Perineural involvement at the time of diagnosis is associated with poor survival in patients with colorectal cancer. The use of this prognostic indicator should help to guide future treatment algorithms.

Figure: Figure 1: Kaplan-Meier Survival Curves and Log-Rank Analysis showing the difference in overall survival between patients with and without perineural invasion

Prognostic Factors

Adjusted Hazard Ratio (HR) and 95% CI

P-value

Perineural invasion

Absent

Present

Ref.

1.55 (1.48-1.62)

< 0.001

Age, in years

0-59

60-69

70-79

≥80

Ref.

1.40 (1.34-1.47)

2.21 (2.12-2.32)

4.42 (4.24-4.62)

< 0.001

Gender

Female

Male

Ref

1.11 (1.07-1.14)

< 0.001

Stage at Diagnosis

Carcinoma-in-Situ

III

Unknown

Ref.

0.89 (-.77-1.04)

1.26 (1.08-1.46)

1.84 (1.58-2.14)

6.56 (5.63-7.63)

2.98 (2.52-3.51)

0.144

0.004

< 0.001

Grade

Unknown

Ref.

1.07 (1.0-1.14)

1.53 (1.42-1.65)

1.67 (1.54-1.87)

1.07 (1.00-1.17)

0.072

< 0.001

0.104

Surgery of the Primary Site

No surgery

Local tumor destruction/excision

Colectomy

Not specified surgery

Unknown

Ref.

0.37 (0.34-0.42)

0.35 (0.33-0.37)

0.41 (0.27-0.64)

0.001 (0.00-)

< 0.001

0.884

Table: Table 1: Prognostic factors associated with poor overall survival in patients with colorectal cancer

Disclosures:

Usman Tariq indicated no relevant financial relationships.

Azeem Malik indicated no relevant financial relationships.

Bandhul Hans indicated no relevant financial relationships.

Rahul Karna indicated no relevant financial relationships.

Heitham Abdul-Baki indicated no relevant financial relationships.

Usman Tariq, MD¹, Azeem Malik, MD², Bandhul Hans, MD¹, Rahul Karna, MD¹, Heitham Abdul-Baki, MD¹. P1180 - Is Perineural Invasion Associated With Poor Survival Among Patients With Colorectal Cancer? A Surveillance, Epidemiology and End-Results (SEER) Database Analysis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.