Prognostic impact of perineural invasion and lymphovascular invasion in advanced stage oral squamous cell carcinoma

• Published in: International journal of oral and maxillofacial surgery 2015-01, Vol.44 (1), p.23-28
• Main Authors: Jardim, J.F, Francisco, A.L.N, Gondak, R, Damascena, A, Kowalski, L.P
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Chemoradiotherapy; Combined Modality Therapy; Dentistry; Female; Humans; Lymph Node Excision; Lymphatic Metastasis; Male; Middle Aged; Mouth Neoplasms - pathology; Mouth Neoplasms - surgery; Neck Dissection; Neoplasm Invasiveness; Neoplasm Staging; oral cancer; perineural invasion; Prognosis; Retrospective Studies; Risk Factors; squamous cell carcinoma; Surgery; survival; Survival Rate; vascular invasion
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2014.10.006

Abstract Perineural invasion (PNI) and lymphovascular invasion (LVI) have been associated with the risk of local recurrences and lymph node metastasis. The aim of this study was to evaluate the prognostic impact of PNI and LVI in patients with advanced stage squamous cell carcinoma of the tongue and floor of the mouth. One hundred and forty-two patients without previous treatment were selected. These patients underwent radical surgery with neck dissection and adjuvant treatment. Clinicopathological data were retrieved from the medical charts, including histopathology and surgery reports. Univariate analysis was performed to assess the impact of studied variables on survival. Overall survival was negatively influenced by six tumour-related factors: increasing T stage ( P = 0.003), more than two clinically positive nodes ( P = 0.002), extracapsular spread of lymph node metastasis ( P < 0.001), tumour thickness ( P = 0.04), PNI ( P < 0.001), and LVI ( P = 0.012). Disease-free survival was influenced by PNI ( P = 0.04), extracapsular spread of lymph node metastasis ( P = 0.008), and N stage ( P = 0.006). Multivariate analysis showed PNI to be an independent predictor for overall survival ( P = 0.01) and disease-free survival ( P = 0.03). Thus the presence of PNI in oral carcinoma surgical specimens has a significant impact on survival outcomes in patients with advanced stage tumours submitted to radical surgery and adjuvant radiotherapy/radiochemotherapy.