Open AccessPerineural Invasion in Early Stage Oral Tongue Cancer
Author(s) -
Maxwell Jessica H.,
Lezner Diana,
McHugh Jonathan,
Duvvuri Umamaheswar
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811416318a98
Subject(s) - medicine , perineural invasion , tongue , incidence (geometry) , stage (stratigraphy) , cancer , gastroenterology , oncology , pathology , paleontology , physics , optics , biology
Objective 1) Determine the true incidence of perineural invasion (PNI) in patients with squamous cell carcinoma of the oral tongue (SCCOT). 2) Understand the relationship between PNI, tumor thickness, and nodal metastases. 3) Analyze the effect of PNI on overall survival (OS). Method Tumor tissue from 47 patients with early stage SCCOT diagnosed between 1981 and 2001 at the University of Pittsburgh was prospectively analyzed for PNI, number/size of nerves involved, intraneural invasion, nodal metastases, and tumor thickness. Outcome data included overall survival, disease‐specific survival, and disease recurrence. Results PNI was found in 48.9% (23/47) of patients. At initial diagnosis, the incidence of PNI was 36.8% (7/19) among those patients evaluated for PNI. This agreement was fair (Kappa = 0.39, 95% CI:0.02, 0.76). Patients with PNI had significantly greater tumor thickness (mean = 13.2mm) than patients without PNI (mean = 6.9mm; P =. 001). Three (3/23; 13%) patients with PNI had intraneural invasion. Ten of 23 (43.5%) patients with PNI had nodal metastases compared with 4 of 20 (16.7%) patients without PNI ( P =. 060). Patients without PNI had better OS than patients with PNI (median = 10.1 years vs 4.2 years, respectively), although this was not significant ( P =. 154). Conclusion The true incidence of PNI is nearly 50% for SCCOT. PNI is significantly associated with greater tumor thickness. Patients with PNI have increased nodal metastases and worse overall survival compared to patients without PNI. However, these trends are not significant.