Hello everyone!

Pretty much all the information related to the case is present in my signature.

My dad just had surgery (also mentioned in the signature) and the histopathological reports showed the presence of PNI. Doctors will tell us what is the planned course of action coming Friday. Before that I wanted to gain some knowledge to make sure that we opt for the best treatment strategy. Now, I went through some research papers and I have the following information (feel free to correct me):

• PNI in general increases the probability of locoregional recurrence (recurrence in the same place), distant metastasis and reduces the disease free survival period.
• PNI presence often calls for adjuvant radiotherapy.
• Whether or not radiotherapy helps depends on a lot of factors, including the focality of PNI
• Till now there is no conclusive research on whether chemotherapy helps specifically for PNI or not

Now, I have the following questions (as of now):

• If margins and nodes are clear of tumour and PNI was detected in tumour, does that not mean that the nerve branch where PNI was present has been cut off and tumour was not able to reach the margins or the nodes from that nerve? Since the margins and nodes are clear of tumour, so why should the probability of LR increase? Similarly, why should the survival period decrease?
• Is there anyone else who faced a similar situation? pT1N0M0 with PNI present? What did you do?

Looking forward to some helpful information from you guys.
Kind regards
worried son