Vascular and neural invasion in colorectal carcinoma.Incidence and prognostic significance

Abstract

The incidence and significance of histologic vascular and/or neural invasion in 77 patinets with colorectal carcinoma treated over a 6-year period were analyzed retrospectively. Vascular invasion was found in 37.6% of patients and neural invasion in 14.3%. The following three types of vascular invasion were identified: tumor lining epithelium, tumor thrombi, and destruction of the vessel wall. The incidence of metastases in patients with vascular invasion was 60% as opposed to 17% in those without vascular invasions (P < 0.0001). Survival in these patients was 29.7% and 62.2%, respectively (P < 0.003). Metastases were found in 72.7% of patients with neural invasion, as opposed to 27% of those without neural invasion (P < 0.01). Survival was 29.6% as opposed to 57.7% in those without neural invasion (P < 0.003). Even among patients in the same Dukes'' stage, prognosis, as determined by incidence of recurrence, metastases, and survival, was worse significantly among those patients demonstrating vascular invasion (P < 0.03). Examination of patients with colorectal carcinoma for the presence of vascular and neural invasion may provide useful information for determining future treatment and prognosis.