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Perineural invasion in squamous cell carcinoma of the oral cavity: histology, tumor stage and outcome


Laske, Roman D; Scholz, Irene; Ikenberg, Kristian; Meerwein, Christian; Vital, Domenic; Studer, Gabriela; Rössle, Matthias; Huber, Gerhard F (2016). Perineural invasion in squamous cell carcinoma of the oral cavity: histology, tumor stage and outcome. Laryngoscope Investigative Otolaryngology, 1(1):13-18.

Abstract

Objectives/Hypothesis: To analyze the impact of different types of perineural invasion (PNI) in squamous cell carcinoma (SCC) of the oral cavity on overall survival and recurrence rate, with a special focus on histologic subtypes and tumor stage.
Study Design: Retrospective case-control study with clinicopathological analysis.
Methods: Seventeen patients who received primary surgical treatment for SCC of the oral cavity with PNI were matched to a control group. In a histologic review, PNI was classified into subtypes according to an adapted Liebig classification. The term type A was used to describe tumor invasion into the nerve, whereas type B was used to describe circumferential growth around the nerve. Clinical charts were reviewed, and a Kaplan-Meier survival analysis was performed.
Results: The recurrence-free survival rates were 47.1% versus 80.4% (PNI vs. matched control group, P < 0.05), 60.0% versus 94.1% (PNI in stage I and II disease vs. matched control group, P < 0.05) and 41.7% versus 73.5% (PNI in stage III and IV disease vs. matched control group, P < 0.05). In most cases (n = 9) of PNI, both histologic subtypes (type A and type B) were present. Five cases exclusively showed type A, and three cases exclusively showed type B.
Conclusions: Perineural invasion in early disease oral carcinoma has a particularly high impact on survival. Both histologic subtypes showed a significantly worse recurrence-free survival rate when compared to the control group.
Level of Evidence: 3.

Abstract

Objectives/Hypothesis: To analyze the impact of different types of perineural invasion (PNI) in squamous cell carcinoma (SCC) of the oral cavity on overall survival and recurrence rate, with a special focus on histologic subtypes and tumor stage.
Study Design: Retrospective case-control study with clinicopathological analysis.
Methods: Seventeen patients who received primary surgical treatment for SCC of the oral cavity with PNI were matched to a control group. In a histologic review, PNI was classified into subtypes according to an adapted Liebig classification. The term type A was used to describe tumor invasion into the nerve, whereas type B was used to describe circumferential growth around the nerve. Clinical charts were reviewed, and a Kaplan-Meier survival analysis was performed.
Results: The recurrence-free survival rates were 47.1% versus 80.4% (PNI vs. matched control group, P < 0.05), 60.0% versus 94.1% (PNI in stage I and II disease vs. matched control group, P < 0.05) and 41.7% versus 73.5% (PNI in stage III and IV disease vs. matched control group, P < 0.05). In most cases (n = 9) of PNI, both histologic subtypes (type A and type B) were present. Five cases exclusively showed type A, and three cases exclusively showed type B.
Conclusions: Perineural invasion in early disease oral carcinoma has a particularly high impact on survival. Both histologic subtypes showed a significantly worse recurrence-free survival rate when compared to the control group.
Level of Evidence: 3.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Otorhinolaryngology
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Perineural invasion; head and neck; squamous cell carcinoma; oral; histology
Language:English
Date:14 January 2016
Deposited On:01 Feb 2016 10:12
Last Modified:22 Nov 2017 02:00
Publisher:Wiley Open Access
ISSN:2378-8038
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1002/lio2.4

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