Pathologic process with tumor invasion of nervous structures and spread along the nerve sheath.
Likely involves complex signaling between malignant cells, the stroma and nerves.
Tumors that have perineural tumor invasion have a poor prognosis and a more aggressive tumor: this is particularly true for head and neck cancer and prostate cancer.
This process is currently not a required feature of pathology reports for most malignancies.
Rectal cancers have a greater incidence of PTI than colon cancers because of the autonomic nerve plexus surrounding the rectum (Liebig C).
PTI is associated with more aggressive disease in rectal cancers and explains that stage for stage rectal cancers have worse outcomes than: cancers (Liebig C).
The ascending and descending colon cancers, in the retroperitoneum, have higher incidence of PTI then an unattached tumors of the transverse and sigmoid colon, suggesting the proximity of these tumors to the autonomic nerve rich retroperitoneum increase the likelihood of this process.
This process is associated with more advanced colorectal cancer disease with poor tumor differentiation and higher stage.
This process was associated with a fivefold increase in metastatic disease at the time of diagnosis of colorectal cancer (Liebig C).
In pancreatic cancer intra-pancreatic PTI is correlated with the amount of extra- pancreatic neuronal plexus invasion (Takahashi T).