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

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

Risultato della ricerca: Articlepeer review

8 Citazioni (Scopus)


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. © Wolters Kluwer Health, Inc. All rights reserved.
Lingua originaleEnglish
pagine (da-a)70-76
Numero di pagine7
Stato di pubblicazionePublished - 2019

All Science Journal Classification (ASJC) codes

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  • ???subjectarea.asjc.2700.2712???
  • ???subjectarea.asjc.2700.2721???
  • ???subjectarea.asjc.1300.1310???


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