Prognostic value of lymphatic vessel and neural invasion in colorectal carcinoma

The paradoxical evolution of approximately one third of patients with colorectal cancer cataloged in Dukes stages B and C demonstrates the necessity of make useful other prognostic criteria. The presence of neural and lymphatic invasion of tumor cells was correlated with the prognosis of patients submitted to radical operation. We performed a retrospective study on 320 patients with colo-rectal carcinoma, with mean age 58 years and 199 (62.2%) females. Neural invasion was assessed as positive if cancer cells infiltration into the perineurium or neural fasciculus was detected at the leading point. Lymphatic invasion was defined by cancer cells infiltration into a space limited by endothelium without muscular or elastic fibers. Those variable were associated to the original classification of Dukes. Lymphatic and neural invasion was demonstrated in 14.1% and 15% of 320 operation specimens respectively. The most frequent site of lymphatic and neural invasion was the rectum. The overall survival was 25% in the presence of neural invasion and 64% without neural invasion (p