Carcinoma of the skin of the head and neck with perineural invasion

Mendenhall, William M.; Parsons, James T.; Mendenhall, Nancy P.; Brant, Timothy A.; Stringer, Scott P.; Cassisi, Nicholas J.; Million, Rodney R.

doi:10.1002/hed.2880110404

Cited by 113 publications

(98 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…21 The results reported by Ampil et al, who performed aggressive surgery with or without XRT for patients with extensive PNI, differed somewhat from the other studies, with a local control rate of 66.7% and 100% 5-and 10-year disease-free survival rates. 26 Later studies, which divided patients into groups with microscopic or extensive PNI, demonstrated that patients who had microscopic PNI had local control rates of 78% to 87% after treatment compared with patients who had extensive PNI (local control rates, 50-55%) 10,16,20,25 (Table 2). Table 3 summarizes local control rates of patients who had SCC with PNI based on their imaging results.…”

Section: Resultsmentioning

confidence: 83%

“…10,14,16,20,21,24,25 Patients who underwent MMS with or without XRT achieved superior local control rates of 92% to 100%. 13,15,18,24 Early studies, which consisted almost entirely of patients who were symptomatic or who had imaging-positive disease (ie, clinical PNI) demonstrated local control rates at the lower end of the spectrum, ranging from 38% to 53%, 14,21,24 with 1 reported 5-year survival rate of 33%. 21 The results reported by Ampil et al, who performed aggressive surgery with or without XRT for patients with extensive PNI, differed somewhat from the other studies, with a local control rate of 66.7% and 100% 5-and 10-year disease-free survival rates.…”

Section: Resultsmentioning

confidence: 99%

“…13,15,18,24 Early studies, which consisted almost entirely of patients who were symptomatic or who had imaging-positive disease (ie, clinical PNI) demonstrated local control rates at the lower end of the spectrum, ranging from 38% to 53%, 14,21,24 with 1 reported 5-year survival rate of 33%. 21 The results reported by Ampil et al, who performed aggressive surgery with or without XRT for patients with extensive PNI, differed somewhat from the other studies, with a local control rate of 66.7% and 100% 5-and 10-year disease-free survival rates. 26 Later studies, which divided patients into groups with microscopic or extensive PNI, demonstrated that patients who had microscopic PNI had local control rates of 78% to 87% after treatment compared with patients who had extensive PNI (local control rates, 50-55%) 10,16,20,25 (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…It cannot be detected on radiographic studies and is associated with minimal morbidity or mortality. 18,20 It has been estimated that from 60% to 70% of all patients with PNI have microscopic findings, 5,21 which have also been termed incidental findings in the literature. Because both microscopic and widespread evidence of PNI may be identified at the time of surgery, in this article, we have classified minimal PNI as microscopic rather than incidental.…”

Section: Discussionmentioning

confidence: 99%

“…1,8 The presence of PNI in patients with SCC often is associated with aggressive clinical behavior, an increased risk of recurrence and metastasis, and a poorer prognosis. 5,[9][10][11] Risk factors for PNI in SCC include male sex, tumor size >2 cm, midfacial tumor location, recurrent tumor, less well differentiated histologic subtypes, and significant subclinical extension. [11][12][13][14][15][16] Patients with SCC who have risk factors for PNI require an organized approach to their evaluation, because early detection of PNI maximizes the chance of effective treatment.…”

Section: Methodsmentioning

confidence: 99%

See 4 more Smart Citations

What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion?

Han

Ratner

2007

Cancer

143

108

View full text Add to dashboard Cite

BACKGROUND.Perineural invasion (PNI) in cutaneous squamous cell carcinoma (SCC) is infrequent, occurring in 2.5% to 14% of patients, but it is important prognostically, because it carries an increased risk of recurrence and metastasis. Although both excision and Mohs micrographic surgery (MMS) are used to treat SCC with PNI, postoperative radiation therapy (XRT) often is recommended to minimize the risk of recurrence. To date, the effectiveness of adjuvant XRT in this setting has not been determined definitively.METHODS.The authors evaluated the effectiveness of adjuvant XRT in treating SCC with PNI by performing a thorough literature review.RESULTS.For SCC with PNI, the local control rate after MMS with or without XRT was from 92% to 100% compared with a control rate from 38% to 100% after standard excision with or without XRT. A better prognosis was associated with negative pretreatment magnetic resonance imaging or computed tomography findings than with positive radiographic evidence of PNI. Primary SCC with PNI was associated with better local control than recurrent SCC with PNI. When treatment outcomes were stratified by PNI type, SCC with microscopic PNI and SCC with extensive PNI had local control rates from 78% to 87% and from 50% to 55%, respectively. Adjuvant XRT was associated in selected patients with 100% local control.CONCLUSIONS.Few studies addressed the effectiveness of adjuvant XRT in patients who have SCC with PNI. Although XRT has been established as an adjuvant treatment for selected patients, the extent of nerve involvement by tumor, particularly in the setting of other high‐risk features, may be helpful in defining its role. In the future, a multicentered, prospective, randomized clinical trial will be needed to assess the true efficacy of adjuvant XRT in the treatment of patients with SCC and PNI. Cancer 2007 © 2007 American Cancer Society.

show abstract

Section: Resultsmentioning

confidence: 83%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion?

Han

Ratner

2007

Cancer

143

108

View full text Add to dashboard Cite

show abstract

Clinical and Incidental Perineural Invasion of Cutaneous Squamous Cell Carcinoma

et al. 2017

View full text Add to dashboard Cite

IMPORTANCE Perineural invasion (PNI) in cutaneous squamous cell carcinoma (CSCC) has been associated with an increased risk of poor outcomes. Patients with PNI may present with clinical symptoms and/or radiologic evidence of PNI (clinical PNI [CPNI]), yet most patients are asymptomatic and PNI is often found on histologic examination (incidental PNI [IPNI]). Evidence-based estimates of the risks of disease-related outcomes comparing IPNI and CPNI are limited in the dermatology literature.OBJECTIVES To review and synthesize outcomes data for patients with CSCC and CPNI or IPNI.DATA SOURCES A systematic review was conducted in MEDLINE and EMBASE for English-language articles published since inception to November 11, 2016.STUDY SELECTION All studies that reported a disease-related outcome (local recurrence, nodal metastasis, distant metastasis, or disease-specific death) of CSCCs with CPNI and IPNI were included.DATA EXTRACTION AND SYNTHESIS Articles were screened for eligibility, and any possible discrepancies in this screening were resolved. Data extracted included study characteristics, tumor characteristics, treatments performed, and disease-related outcomes. Overall risks of disease-related outcomes were generated by pooling patients from eligible studies. χ 2 Statistics and Fisher exact tests were used to evaluate differences in disease-related outcomes.MAIN OUTCOMES AND MEASURES Risks of disease-related outcomes and 5-year recurrence-free, disease-specific, and overall survival. RESULTS A total of 12 studies containing 241 patients with CPNI and 381 patients with IPNI were included in the systematic review and analysis. The overall risks of local recurrence and disease-specific death were significantly higher in patients with CSCC and CPNI compared with those with CSCC and IPNI (local recurrence, 37% vs 17%; P < .001; disease-specific death, 27% vs 6%; P < .001). The risks of nodal metastasis and distant metastasis did not differ significantly by PNI classification. Patients with CSCC and CPNI had poorer mean 5-year recurrence-free survival and disease-specific survival compared with patients with IPNI (recurrence-free survival, 61% vs 76%; P = .009; disease-specific survival, 70% vs 88%; P = .002). CONCLUSIONS AND RELEVANCEPatients with CSCC and CPNI are at an increased risk of local recurrence and disease-specific death compared with patients with CSCC and IPNI and have a 30% risk of death. Patients with PNI may benefit from increased long-term surveillance. Further studies are needed to establish standardized guidelines on follow-up and dermatologic surveillance in this high-risk patient population.

show abstract

Perineural spread of basal cell carcinomas treated with Mohs micrographic surgery

Ratner

Lowe

Johnson

et al. 2000

Cancer

108

View full text Add to dashboard Cite

Carcinoma of the skin of the head and neck with perineural invasion

Cited by 113 publications

References 13 publications

What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion?

What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion?

Clinical and Incidental Perineural Invasion of Cutaneous Squamous Cell Carcinoma

Perineural spread of basal cell carcinomas treated with Mohs micrographic surgery

Contact Info

Product

Resources

About