Perineural Invasion by Squamous‐Cell Carcinoma

Cottel, Willis I.

doi:10.1111/j.1524-4725.1982.tb00317.x

Cited by 166 publications

(128 citation statements)

References 21 publications

(16 reference statements)

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“…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%

“…Paralysis of the facial nerve can be tested by using the Schirmer test, taste test, and impedance audiometry. 18 Ptosis, ophthalmoplegia, or visual disturbances may suggest involvement of cranial nerves II, III, IV, or VI. In addition to physician assessment of the signs and symptoms of PNI, preoperative imaging studies serve as important adjunctive tools in the initial evaluation of the high-risk SCC patient, as discussed below.…”

Section: Methodsmentioning

confidence: 99%

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

Han

Ratner

2007

Cancer

143

108

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

Han

Ratner

2007

Cancer

143

108

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“…Metastasis to the skull 1 year after treatment was reported in one patient with symptomatic perineural invasion affecting the supraorbital nerve in a further series. 599 In the other three studies, two of which included patients with asymptomatic perineural invasion in unnamed nerves 598,601 and one in which there was involvement of named cranial nerves, 602 there were no reports of recurrence following treatment during follow-up ranging from 10.4 months to 104.8 months.…”

Section: Adjuvant Radiotherapymentioning

confidence: 99%

“…[598][599][600][601][602] In one of these studies, 600 local recurrence occurred in two out of six patients with asymptomatic perineural invasion in nerve branches of 0.4 mm diameter. All excised SCCs had clear surgical margins of at least 3 mm.…”

Section: Adjuvant Radiotherapymentioning

confidence: 99%

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A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

Kim

Batchelor

Bath‐Hextall

et al. 2016

Programme Grants Appl Res

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Programme Grants for Applied ResearchISSN 2050-4322 (Print) ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10177. The contractual start date was in September 2008. The final report began editorial review in April 2014 and was accepted for publication in April 2016. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, CCF, NETSCC, PGfAR or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, ...

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Mohs surgery. Technique, indications, applications, and the future

Swanson¹

1983

Archives of Dermatology

126

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Each year, it is estimated, more than 500,000 new cases of nonmelanoma skin cancer develop. The majority of these cutaneous neoplasms are treated by various modalities that include excision, electrodesiccation and curettage, cryosurgery, and irradiation, with greater than 90% success. Certain of the remaining primary tumors, as well as recurrent carcinomas, present a demanding therapeutic challenge. For these lesions, Mohs surgery has evolved as the most reliable and cost-effective treatment modality, offering maximal preservation of normal tissue and therefore the lowest functional and cosmetic morbidity. In this review, the history and evolution of Mohs surgery and the technique itself will be briefly outlined. The indications for Mohs surgery, together with methods of handling the postoperative wound and future applications of the technique, will be discussed in detail.

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Perineural Invasion by Squamous‐Cell Carcinoma

Cited by 166 publications

References 21 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?

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

Mohs surgery. Technique, indications, applications, and the future

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