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Perineural invasion as an indicator of clinical outcome in vulvar carcinoma (54.2)
Author(s) -
Holthoff Emily,
Jeffus Susanne,
Stone Rebecca,
Gehlot Ashita,
Quick Charles,
Post Steven
Publication year - 2014
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.28.1_supplement.54.2
Subject(s) - perineural invasion , medicine , lymphovascular invasion , pathological , stage (stratigraphy) , malignancy , clinical significance , oncology , vulvar cancer , stromal cell , pathology , carcinoma , cancer , metastasis , paleontology , biology
Vulvar squamous cell carcinoma (vSCC) is a disfiguring malignancy that represents 4% of all gynecological cancers. A pathological feature that is commonly used in determining clinical prognosis and treatment is depth of tumor invasion. Perineural invasion (PNI) is another feature that is sometimes noted in pathology reports; however, the relevance of PNI to clinical outcomes in vSCC patients is not well defined. The purpose of this study was to determine the correlation between PNI and relevant clinical parameters including cancer stage and recurrence. 146 cases of vSCC were evaluated for PNI using pathology report review, H&E morphology, and IHC dual‐chromagen staining for S‐100 & AE1/3. Medical records were reviewed for clinical and follow‐up data. Statistical evaluation was performed using chi‐squared and t‐test calculations to correlate PNI with various parameters. Patients with PNI had a 2.7‐fold higher risk of cancer recurrence (p=0.0298). Furthermore, 50% of patients with stage IV carcinoma had tumor‐associated PNI, whereas PNI was associated with <30% of stages I‐III tumors. PNI was also more closely associated with fibromyxoid stromal response (40%) than inflammatory stromal response (18%); however, this correlation was not statistically significant. Neither lymph node involvement nor lymphovascular infiltration was associated with presence of PNI. Interestingly, our data showed no significant correlation between the presence of PNI and depth of tumor invasion suggesting that PNI is an independent prognostic indicator of cancer recurrence. The significant association of PNI with recurrence, independent of tumor depth of invasion, should cause practicing pathologists to thoroughly search for and report its presence in vSCC.