2015-08-20

Research Article
Perineural invasion in oral squamous cell carcinoma: Quantitative subcategorisation of perineural invasion and prognostication

Karina Aivazian MBBS1, Ardalan Ebrahimi MBBS, MPH, FRACS2,3, Tsu-Hui (Hubert) Low FRACS2, Kan Gao B.Eng3, Anthony Clifford FRACS2, Kerwin Shannon FRACS2, Jonathan R. Clark M. Biostat, FRACS2,3,4 andRuta Gupta MD, FRCPA1,2,4,*
DOI: 10.1002/jso.23821
Journal of Surgical Oncology
Volume 111, Issue 3, pages 352–358,2015
Karina Aivazian and Ardalan Ebrahimi contributed equally to this work.
Keywords:
oral squamous cell carcinoma;perineural invasion;PORT

Background
Evidence regarding the prognostic value of perineural invasion (PNI) in oral squamous cell carcinoma (OSCC) and whether PNI alone warrants consideration of adjuvant therapy is controversial. We evaluated whether histopathological sub-categorization of PNI improves risk stratification.

Methods
PNI was evaluated for nerve size, number of foci, and distance from the tumor in 318 OSCC patients. Univariable and multivariable analyses were performed, with local failure (LF) and disease-specific survival (DSS) as the primary endpoints.

Results
PNI did not influence prognosis when classified as absent versus present. In contrast, multifocal PNI was associated with LF (P = 0.049) and decreased DSS (P = 0.043) on multivariable analyses. The size of the involved nerve separated those with multifocal PNI into intermediate (<1 mm) and high-risk (≥1 mm) groups. Unifocal PNI and distance from the tumor did not influence prognosis. Multifocal PNI was associated with worse prognosis irrespective of post-operative radiotherapy (PORT).

Conclusions
Multifocal PNI is associated with poor outcomes even with PORT suggesting consideration of therapeutic escalation, particularly with involved nerves ≥1 mm. Unifocal PNI did not affect prognosis even in the absence of PORT, which may not be required if this is the sole risk factor. Prospective validation and testing of these hypotheses is essential before implementation. J. Surg. Oncol. 2015 111:352–358. © 2014 Wiley Periodicals, Inc.

Select item 26261575
1.
The status of perineural invasion predicts the outcomes of postoperative radiotherapy in locally advanced esophageal squamous cell carcinoma.
Ning ZH, Zhao W, Li XD, Chen LJ, Xu B, Gu WD, Shao YJ, Xu Y, Huang J, Pei HL, Jiang JT.
Int J Clin Exp Pathol. 2015 Jun 1;8(6):6881-90. eCollection 2015.
PMID: 26261575 Free PMC Article
Similar articles
Select item 25368675
2.
Perineural Invasion and TAMs in Pancreatic Ductal Adenocarcinomas: Review of the Original Pathology Reports Using Immunohistochemical Enhancement and Relationships with Clinicopathological Features.
Zeng L, Guo Y, Liang J, Chen S, Peng P, Zhang Q, Su H, Chen Y, Huang K.
J Cancer. 2014 Oct 22;5(9):754-60. doi: 10.7150/jca.10238. eCollection 2014.
PMID: 25368675 Free PMC Article
Similar articles
Select item 22252234
3.
Plexin-B1 and semaphorin 4D cooperate to promote perineural invasion in a RhoA/ROK-dependent manner.
Binmadi NO, Yang YH, Zhou H, Proia P, Lin YL, De Paula AM, Guimarães AL, Poswar FO, Sundararajan D, Basile JR.
Am J Pathol. 2012 Mar;180(3):1232-42. doi: 10.1016/j.ajpath.2011.12.009. Epub 2012 Jan 15.
PMID: 22252234 Free PMC Article
Similar articles
Select item 22434940
4.
Assessment of the innervation pattern of oral squamous cell carcinoma using neural protein gene product (9.5)-An immunocytochemical study.
Habash FS, Hantash RO, Yunis MA.
J Oral Maxillofac Pathol. 2012 Jan;16(1):16-21. doi: 10.4103/0973-029X.92967.
PMID: 22434940 Free PMC Article
Similar articles
Select item 23227181
5.
Proteomic approaches identify members of cofilin pathway involved in oral tumorigenesis.
Polachini GM, Sobral LM, Mercante AM, Paes-Leme AF, Xavier FC, Henrique T, Guimarães DM, Vidotto A, Fukuyama EE, Góis-Filho JF, Cury PM, Curioni OA, Michaluart P Jr, Silva AM, Wünsch-Filho V, Nunes FD, Leopoldino AM, Tajara EH.
PLoS One. 2012;7(12):e50517. doi: 10.1371/journal.pone.0050517. Epub 2012 Dec 5.
PMID: 23227181 Free PMC Article
Similar articles
Select item 24377033
6.
Role of extended histological examination in the assessment of local recurrence of tongue and floor of the mouth cancer.
Szybiak B, Trzeciak P, Golusiński W.
Rep Pract Oncol Radiother. 2012 Jul 17;17(6):319-23. doi: 10.1016/j.rpor.2012.06.001. eCollection 2012.
PMID: 24377033 Free PMC Article
Similar articles
Select item 22977464
7.
Immunohistochemical analysis of integrins αvβ3, αvβ5 and α5β1, and their ligands, fibrinogen, fibronectin, osteopontin and vitronectin, in frozen sections of human oral head and neck squamous cell carcinomas.
Fabricius EM, Wildner GP, Kruse-Boitschenko U, Hoffmeister B, Goodman SL, Raguse JD.
Exp Ther Med. 2011 Jan;2(1):9-19. Epub 2010 Dec 2.
PMID: 22977464 Free PMC Article
Similar articles
Select item 19738119
8.
Perineural invasion is an independent predictor of outcome in colorectal cancer.
Liebig C, Ayala G, Wilks J, Verstovsek G, Liu H, Agarwal N, Berger DH, Albo D.
J Clin Oncol. 2009 Nov 1;27(31):5131-7. doi: 10.1200/JCO.2009.22.4949. Epub 2009 Sep 8.
PMID: 19738119 Free PMC Article
Similar articles
Select item 18505934
9.
Immunohistochemical method identifies lymphovascular invasion in a majority of oral squamous cell carcinomas and discriminates between blood and lymphatic vessel invasion.
O'Donnell RK, Feldman M, Mick R, Muschel RJ.
J Histochem Cytochem. 2008 Sep;56(9):803-10. doi: 10.1369/jhc.2008.950790. Epub 2008 May 27.
PMID: 18505934 Free PMC Article
Similar articles

Show more