The Impact of Perineural Invasion in Patients with Esophageal Adenocarcinoma Treated with Esophagectomy

Once thought to be a purely passive process, there is emerging evidence that perineural invasion is associated with reciprocal signaling between tumor and nerve cells. Experimental evidence has demonstrated that malignant cells show increased proliferation in the presence of nerves, suggesting that nerve contact may even provide a survival advantage for tumor cells. The presence of perineural invasion is a well-established marker of poor outcome in several types of malignancy including cancers of the stomach and prostate, yet its role in esophageal cancer has not been clearly elucidated. This objective of this study was to examine the prognostic significance of perineural invasion in patients with esophageal adenocarcinoma treated with esophagectomy.