Prognostic value of lymphovascular and perineural invasion in stage II gastric cancer patients

Purpose Lymphovascular invasion(LVI) refers to the presence of cancer cells in lymphatic vessels or blood vessels. Perineural invasion (PNI) is the process of neoplastic invasion of peripheral nerves. The purpose of this study is to explore the prognostic value of stage II gastric cancer patients with LVI and PNI. Methods Of the 554 patients with gastric cancer at stage II, 103 had been examined for LVI and 95 had been examined for PNI. LVI and PNI were assessed through hematoxylin and eosin (HE) staining. Survival outcomes were evaluated using the Kaplan-Meier method, with statistical significance determined by the log-rank test. To identify prognostic factors, both univariate and multivariate analyses were conducted, employing the Cox proportional hazards regression model. Results The LVI status was associated with pT stage, pN stage, serum carcinoembryonic antigen (CEA) levels and tumor size. The PNI status was associated with pT stage, pN stage and serum CEA levels. The 5-year overall survival (OS) rate and the 5-year disease-free survival (DFS) rate of the LVI- group were greater than the LVI + group. Similarly, the 5-year OS rate and the 5-year DFS rate of the PNI- group were greater than the PNI + group. Multivariate analyses showed that pT-stage, LVI, PNI and serum CEA level were significant prognostic factors for stage II GC patients. Conclusions LVI and PNI can reduce the 5-year OS and DFS of stage II gastric cancer patients. The impact of LVI and PNI should be considered when considering the prognosis of stage II patients in clinical practice. In the meantime, we need more effective adjuvant chemotherapy for stage II patients with LVI and PNI.