Multifocal perineural invasion is a better prognosticator than depth of invasion in oral squamous cell carcinoma

Shaheen Hasmat; Ardalan Ebrahimi; Kan Gao; Tsu Hui Low; Carsten Palme; Ruta Gupta; Jonathan Clark

doi:10.1002/hed.25940

Multifocal perineural invasion is a better prognosticator than depth of invasion in oral squamous cell carcinoma

Shaheen Hasmat^*, Ardalan Ebrahimi, Kan Gao, Tsu Hui Low, Carsten Palme, Ruta Gupta, Jonathan Clark

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

25 Citations (Scopus)

Abstract

Objectives: Prognostic significance of perineural invasion (PNI) in oral squamous cell carcinoma (OSCC) characterized as unifocal and multifocal was compared to depth of invasion (DOI) and extranodal extension (ENE). Materials and Methods: Univariable and multivariable analyses of 861 consecutive patients with OSCC undergoing treatment between 1995 and 2018 were performed, with local failure (LF) and disease-specific mortality (DSS) as the primary endpoints. Results: After adjusting for other adverse histopathological factors and adjuvant therapy, multifocal PNI was associated with a greater risk of LF (P =.01) and DSS (P = 0.02) compared to DOI. The effect of multifocal PNI was comparable to the effect of nodal metastases without ENE (P = 0.02). LF and DSS were not improved by the administration of adjuvant radiotherapy within unifocal or multifocal PNI groups. Conclusion: Multifocal PNI is associated with a greater risk of death in OSCC than DOI. Its effect is comparable to that of nodal metastases (without ENE).

Original language	English
Pages (from-to)	3992-3999
Number of pages	8
Journal	Head and Neck
Volume	41
Issue number	11
DOIs	https://doi.org/10.1002/hed.25940
Publication status	Published - 1 Nov 2019

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10.1002/hed.25940

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title = "Multifocal perineural invasion is a better prognosticator than depth of invasion in oral squamous cell carcinoma",

abstract = "Objectives: Prognostic significance of perineural invasion (PNI) in oral squamous cell carcinoma (OSCC) characterized as unifocal and multifocal was compared to depth of invasion (DOI) and extranodal extension (ENE). Materials and Methods: Univariable and multivariable analyses of 861 consecutive patients with OSCC undergoing treatment between 1995 and 2018 were performed, with local failure (LF) and disease-specific mortality (DSS) as the primary endpoints. Results: After adjusting for other adverse histopathological factors and adjuvant therapy, multifocal PNI was associated with a greater risk of LF (P =.01) and DSS (P = 0.02) compared to DOI. The effect of multifocal PNI was comparable to the effect of nodal metastases without ENE (P = 0.02). LF and DSS were not improved by the administration of adjuvant radiotherapy within unifocal or multifocal PNI groups. Conclusion: Multifocal PNI is associated with a greater risk of death in OSCC than DOI. Its effect is comparable to that of nodal metastases (without ENE).",

keywords = "AJCC, depth of invasion, local failure, oral cancer, perineural invasion, radiotherapy, survival",

author = "Shaheen Hasmat and Ardalan Ebrahimi and Kan Gao and Low, {Tsu Hui} and Carsten Palme and Ruta Gupta and Jonathan Clark",

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year = "2019",

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doi = "10.1002/hed.25940",

language = "English",

volume = "41",

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T1 - Multifocal perineural invasion is a better prognosticator than depth of invasion in oral squamous cell carcinoma

AU - Hasmat, Shaheen

AU - Ebrahimi, Ardalan

AU - Gao, Kan

AU - Low, Tsu Hui

AU - Palme, Carsten

AU - Gupta, Ruta

AU - Clark, Jonathan

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Objectives: Prognostic significance of perineural invasion (PNI) in oral squamous cell carcinoma (OSCC) characterized as unifocal and multifocal was compared to depth of invasion (DOI) and extranodal extension (ENE). Materials and Methods: Univariable and multivariable analyses of 861 consecutive patients with OSCC undergoing treatment between 1995 and 2018 were performed, with local failure (LF) and disease-specific mortality (DSS) as the primary endpoints. Results: After adjusting for other adverse histopathological factors and adjuvant therapy, multifocal PNI was associated with a greater risk of LF (P =.01) and DSS (P = 0.02) compared to DOI. The effect of multifocal PNI was comparable to the effect of nodal metastases without ENE (P = 0.02). LF and DSS were not improved by the administration of adjuvant radiotherapy within unifocal or multifocal PNI groups. Conclusion: Multifocal PNI is associated with a greater risk of death in OSCC than DOI. Its effect is comparable to that of nodal metastases (without ENE).

AB - Objectives: Prognostic significance of perineural invasion (PNI) in oral squamous cell carcinoma (OSCC) characterized as unifocal and multifocal was compared to depth of invasion (DOI) and extranodal extension (ENE). Materials and Methods: Univariable and multivariable analyses of 861 consecutive patients with OSCC undergoing treatment between 1995 and 2018 were performed, with local failure (LF) and disease-specific mortality (DSS) as the primary endpoints. Results: After adjusting for other adverse histopathological factors and adjuvant therapy, multifocal PNI was associated with a greater risk of LF (P =.01) and DSS (P = 0.02) compared to DOI. The effect of multifocal PNI was comparable to the effect of nodal metastases without ENE (P = 0.02). LF and DSS were not improved by the administration of adjuvant radiotherapy within unifocal or multifocal PNI groups. Conclusion: Multifocal PNI is associated with a greater risk of death in OSCC than DOI. Its effect is comparable to that of nodal metastases (without ENE).

KW - AJCC

KW - depth of invasion

KW - local failure

KW - oral cancer

KW - perineural invasion

KW - radiotherapy

KW - survival

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U2 - 10.1002/hed.25940

DO - 10.1002/hed.25940

M3 - Article

SN - 1043-3074

VL - 41

SP - 3992

EP - 3999

JO - Head and Neck

JF - Head and Neck

IS - 11

ER -

Multifocal perineural invasion is a better prognosticator than depth of invasion in oral squamous cell carcinoma

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