REVIEW article
Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1629335
This article is part of the Research TopicAdvances in Esophageal Cancer: Treatment Updates and Future ChallengesView all 17 articles
The Impact of Perineural Invasion on Prognosis in Esophageal Cancer Patients After Surgery: A Systematic Review and Meta-Analysis Authors：Jicheng Xiong
Provisionally accepted
Jicheng Xiong1
Shuoming Liang1,2
Simiao Lu Lu1Hainan Chen1Ziwei Wang3Hao Meng3
Yi Zhu4Yongtao Han1
Xuefeng Leng1*- 1Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
- 2School of Clinical Medicine, Chengdu Medical College, Chengdu, China
- 3School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- 4Department of Ultrasound, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
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This study aims to update the prognostic value of perineural invasion(PNI) in various subgroups of esophageal cancer patients.We searched databases including PubMed, Scopus, Wiley, Web of Science, and Embase for full-text articles published in English on esophageal cancer related to PNI. The search was conducted up to January 1, 2024. We summarized the hazard ratios (HR) and 95% confidence intervals (CI) for overall survival (OS), disease-free survival (DFS), as well as recurrence and metastasis, to assess the prognostic value of PNI in patients with esophageal cancer.A total of 38 eligible studies were ultimately included. Thirty-two studies, encompassing a total of 7157 patients, reported the correlation between PNI and OS. The results indicated that PNI is significantly associated with poor OS in esophageal cancer patients (HR = 1.54, 95% CI: 1.41-1.68, P < 0.00001). Eleven studies, including a total of 2224 patients, reported the correlation between PNI and DFS. These studies found that PNI is significantly associated with poor DFS (HR = 1.43, 95% CI: 1.25-1.62, P < 0.00001). Three studies, including a total of 1125 patients, reported no correlation between PNI and recurrence (HR = 1.17, 95% CI: 0.62-2.18, P = 0.63). Two studies, including a total of 556 patients, reported a correlation between PNI and distant metastasis (HR = 2.19, 95% CI: 1.02-4.73, P = 0.04). Further subgroup analysis revealed that PNI is an independent prognostic factor for esophageal squamous cell carcinoma (ESCC) (OS: HR=1.
Keywords: esophageal cancer, esophageal squamous cell carcinoma, Perineural invasion, prognosis, Neoadjuvant Therapy
Received: 15 May 2025; Accepted: 11 Aug 2025.
Copyright: © 2025 Xiong, Liang, Lu, Chen, Wang, Meng, Zhu, Han and Leng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xuefeng Leng, Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China
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