Neural invasion severity is a strong predictor of local recurrence in pancreatic ductal adenocarcinoma

作者：Stephan Schorn, Anouk Fritz, Georgios Kaissis, Matthias M. Gaida, Katja Steiger, Carsten Jäger, Anna Melissa Schlitter, Rickmer Braren, Helmut Friess, İhsan Ekin Demir, Güralp O. Ceyhan · 发表于：Surgery · 年份：2025 · DOI：10.1016/j.surg.2024.109018 · 被引用次数：7 · 研究领域：Pancreatic and Hepatic Oncology Research、Neuroendocrine Tumor Research Advances、Esophageal Cancer Research and Treatment

BACKGROUND: In pancreatic ductal adenocarcinoma, neural invasion is being increasingly recognized as an unfavorable predictor of patient outcomes. Neural invasion severity seems to have a stronger clinical impact on patient prognosis than neural invasion status alone. Therefore, this study aims to assess the impact of severity of neural invasion on overall survival and disease-free survival in pancreatic ductal adenocarcinoma. MATERIALS: To assess the impact of intrapancreatic neural invasion severity, tumor specimens resected from patients with pancreatic ductal adenocarcinoma between 2007 and 2014 were systematically re-evaluated, and neural invasion severity was determined using the standardized neural invasion severity score. RESULTS: In our cohort (n = 216), an increased neural invasion severity score was associated with markedly shorter overall survival in pancreatic head ductal adenocarcinoma (neural invasion severity score low: 22.8 months vs neural invasion severity score high: 17.6 months: P = .001). An external European validation cohort confirmed these results and showed significantly better survival of patients with lower neural invasion (20.5 vs 15.4 months, P = .026). The disease-free survival time was also substantially decreased in patients with pancreatic head pancreatic ductal adenocarcinoma and increased neural invasion severity (neural invasion severity score low: 19.1 months vs neural invasion severity score high: 10.4 months; P = .004). Moreover, the ne...