The impact of multifocal perineural invasion in predicting survival in patients with oral squamous cell carcinoma: A multicenter investigation

Shaheen Hasmat; Gillian Heller; Lachlan Cook; Ruta Gupta; Jonathan R Clark; Eng H Ooi; Tsu-Hui Hubert Low

doi:10.1002/hed.27485

The impact of multifocal perineural invasion in predicting survival in patients with oral squamous cell carcinoma: A multicenter investigation

Head Neck. 2023 Oct;45(10):2605-2612. doi: 10.1002/hed.27485. Epub 2023 Aug 10.

Authors

Shaheen Hasmat^{1

2}, Gillian Heller², Lachlan Cook^{3

4}, Ruta Gupta^{1

2

5}, Jonathan R Clark^{1

2

6}, Eng H Ooi^{3

4}, Tsu-Hui Hubert Low^{1

2

7}

Affiliations

¹ Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
² Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
³ Department of Otolaryngology - Head and Neck Surgery, Flinders Medical Centre and Royal Adelaide Hospital, Adelaide, South Australia, Australia.
⁴ Department of Surgery, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
⁵ Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, New South Wales, Australia.
⁶ Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia.
⁷ Department of Otolaryngology - Head & Neck Surgery, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.

PMID: 37563878
DOI: 10.1002/hed.27485

Abstract

Background: Perineural invasion (PNI) in oral squamous cell carcinoma (OSCC) does not contribute to the current American Joint Committee on Cancer 8th edition (AJCC8) staging manual. This study seeks to validate the effect of multifocal PNI in a large cohort of patients.

Methods: Patients undergoing primary surgical treatment of OSCC with curative intent between 1995 and 2022 was retrieved from two Australian head and neck databases. PNI was categorized as a single focus or multiple foci. Study end points included disease-specific survival (DSS) and overall survival (OS).

Results: Complete data for survival analysis was available in 993 patients. Multifocal PNI was associated with a 61% increased risk of death due to OSCC (HR 1.61, 95% CI 1.11-2.33, p = 0.014) and a 32% increased risk of death from any cause (HR 1.32, 95% CI 1.01-1.73, p = 0.045).

Conclusions: Multifocal PNI is a significant predictor of survival in OSCC.

Keywords: AJCC; oral cancer; perineural invasion; squamous cell carcinoma; survival.

Publication types

Multicenter Study

MeSH terms

Australia / epidemiology
Carcinoma, Squamous Cell* / pathology
Head and Neck Neoplasms* / pathology
Humans
Mouth Neoplasms* / pathology
Neoplasm Invasiveness / pathology
Neoplasm Staging
Prognosis
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck / pathology