{"doi":"10.1002/jso.26367","title":"Concurrent lymphovascular and perineural invasion after preoperative therapy for gastric adenocarcinoma is associated with decreased survival","abstract":"BACKGROUND AND OBJECTIVES: We sought to evaluate the impact of lymphovascular invasion (LVI) and perineural invasion (PNI) on survival outcomes in gastric cancer patients treated with preoperative therapy. METHODS: Patients with gastric cancer treated with preoperative therapy and potentially curative resection were stratified according to the presence of LVI, PNI, or both. Kaplan-Meier and Cox regression analyses were used to evaluate the impact on overall survival (OS) and disease-free survival (DFS). RESULTS: The study included 281 patients, of whom 93 (33%) had LVI, 69 (25%) had PNI, 51 (18%) had both LVI and PNI, and 170 (61%) had neither. LVI and PNI were each associated with higher ypT and ypN categories and more positive lymph nodes (all p < .001), associations that were emphasized with both factors present. On multivariable analyses, ypN (p < .001) and concurrent LVI/PNI (hazard ratio [HR]: 2.62; 95% confidence interval [CI]: 1.55-4.45; p = .001) were predictive of OS and DFS (ypN: p < .001; both LVI/PNI: HR: 2.27; 95% CI: 1.34-3.82; p = .002). CONCLUSIONS: Gastric cancer patients with concurrent LVI and PNI after preoperative therapy have more advanced disease and worse survival outcomes than patients with neither or only one of these factors.","journal":"Journal of Surgical Oncology","year":2021,"id":176992,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9654,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":495509,"name":"Timothy E. Newhook","orcid":"0000-0001-6663-459X","position":1,"is_corresponding":false},{"id":341840,"name":"Naruhiko Ikoma","orcid":"0000-0002-9825-9234","position":2,"is_corresponding":false},{"id":341837,"name":"Jeannelyn S. Estrella","orcid":"0000-0003-3705-5964","position":3,"is_corresponding":false},{"id":474412,"name":"Mariela Blum Murphy","orcid":null,"position":4,"is_corresponding":false},{"id":341838,"name":"Prajnan Das","orcid":"0000-0002-3845-0707","position":5,"is_corresponding":false},{"id":72433,"name":"Bruce D. Minsky","orcid":"0000-0001-8434-7930","position":6,"is_corresponding":false},{"id":69924,"name":"Jaffer A. Ajani","orcid":"0000-0001-9946-0629","position":7,"is_corresponding":false},{"id":401342,"name":"Paul F. Mansfield","orcid":null,"position":8,"is_corresponding":false},{"id":341839,"name":"Brian D. Badgwell","orcid":"0000-0002-9915-8355","position":9,"is_corresponding":false},{"id":400639,"name":"Alisa N. Blumenthaler","orcid":"0000-0001-8830-8509","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":null,"created_at":"2026-07-18T23:47:28.018172Z","pmid":"33400838","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}