A new predictive score identifies patients at risk for perineural invasion (PNI) in colorectal cancer, impacting surgical management and outcomes.

• PNI was found in 13.1% of patients; it predicts a 5-year overall survival of 54% versus 76.4% without PNI.
• Key predictors include age, male sex, race, tumor location, histology, and elevated carcinoembryonic antigen (CEA) levels.
• The Cleveland Clinic Florida score has a negative predictive value of 93%, aiding in patient selection for surgery.

Consider this score in multidisciplinary discussions for improved surgical decision-making.