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Recent studies showed that stent placement in obstructive colon cancer increases the frequency of <jats:styled-content style=\"fixed-case\">PNI<\/jats:styled-content>. We hypothesized that mechanical stress including obstruction itself may be associated with <jats:styled-content style=\"fixed-case\">PNI<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We retrospectively reviewed 496 patients with pathological T3 or T4 colon cancer who did not receive preoperative treatment. Data were collected from medical charts and pathological findings. The relationships between <jats:styled-content style=\"fixed-case\">PNI<\/jats:styled-content> and other clinicopathological factors were analysed using univariate and multivariate analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PNI was observed in 239 (48%) patients. Obstruction was markedly more frequent in <jats:styled-content style=\"fixed-case\">PNI<\/jats:styled-content>\u2010positive cancer (39%) than in <jats:styled-content style=\"fixed-case\">PNI<\/jats:styled-content>\u2010negative cancer (24%, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.0003). Multivariate analyses identified obstruction as one of the significant factors associated with <jats:styled-content style=\"fixed-case\">PNI<\/jats:styled-content> (OR 1.68, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.028). Moreover, in 414 patients without distant metastasis who underwent complete resection, <jats:styled-content style=\"fixed-case\">PNI<\/jats:styled-content> was an independent factor associated with poor recurrence\u2010free survival (hazard ratio 2.35, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003). The coexistence of <jats:styled-content style=\"fixed-case\">PNI<\/jats:styled-content> and obstruction resulted in greater decreases in recurrence\u2010free survival than <jats:styled-content style=\"fixed-case\">PNI<\/jats:styled-content>\u2010negative and\/or non\u2010obstructive cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results suggest that obstruction is associated with <jats:styled-content style=\"fixed-case\">PNI<\/jats:styled-content> and consequently contributes to an increased postoperative recurrence in colon cancer.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14655","type":"journal-article","created":{"date-parts":[[2019,4,24]],"date-time":"2019-04-24T15:52:09Z","timestamp":1556121129000},"page":"917-924","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Obstruction is associated with perineural invasion in T3\/T4 colon 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