Large nerve diameter in tumor bulk associates with poor DSS. A, Patients are divided in tertiles for maximum nerve diameter in tumor bulk into low (≤32.28 μm), medium (33.73–88.13 μm), and large (≥ 89.61 μm). Patients with large nerves in the tumor bulk survive poorly. B, Among PNI-negative patients, nerve diameter ≥32 μm in the tumor bulk significantly associates with poor DSS. C, Adjusted Cox modeling of nerve-level data. Data are weighted by the number of nerves per patient and adjusted for variables shown in the table. Significant HRs are shown in bold and depicted in orange for high. D, Adjusted Cox additive modeling for relative DSS as a function of nerve diameter in the tumor bulk using nerve-level data; an increase in relative DSS death rate is observed as nerve diameter increases. The model is adjusted for AJCC 7th edition stage and tumor differentiation. E, Among node-negative patients, a nerve diameter ≥32 μm associates with poor DSS. Kaplan–Meier survival curves using patient-level data are shown in A, B, and E. Log-rank P values are displayed in each plot and the number of patients at risk for each timepoint is shown below each survival plot. PNI was assessed using H&E + IHC.