Skin cancer of the head and neck with clinical perineural invasion

McCord, Mark W.; Mendenhall, William M.; Parsons, James T.; Amdur, Robert J.; Stringer, Scott P.; Cassisi, Nicholas J.; Million, Rodney R.

doi:10.1016/s0360-3016(99)00533-7

Cited by 144 publications

(140 citation statements)

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“…Patients who underwent standard excision with or without receiving XRT had local control rates that ranged from 38% to 87%. 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%.…”

Section: Resultsmentioning

confidence: 99%

“…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: 99%

“…The difference between the local control rates achieved with MMS versus standard excision with or without XRT for SCC with PNI is striking, with reported local control rates from 92% to 100% for MMS 13,15,18,24 compared with control rates from 38% to 87% for standard excision. 10,14,16,20,21,24,25 Because MMS examines the entire peripheral and deep margin of the surgical specimen, it provides the greatest likelihood of complete tumor excision. It is important to note, however, that, if a nerve is surrounded only partially by tumor, then a twist or turn in the specimen during tissue sectioning may result in a false-negative margin or a skip area, leaving undetected residual tumor cells behind.…”

Section: Discussionmentioning

confidence: 99%

“…It is important to separate these 2 groups, because patients who have microscopic PNI have a better prognosis than patients who have extensive PNI, with 78% to 87% local con-trol rates compared with 50% to 55% local control rates after aggressive treatment with XRT with or without surgery. 10,16,20,25 Despite better outcomes, microscopic PNI has been linked with subsequent proximal recurrence along the nerve and poor salvage rates in some patients. For this reason, McCord et al recommend treating all patients who have microscopic PNI with XRT, and their approach has yielded a 77% overall local control rate.…”

Section: Discussionmentioning

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

142

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: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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

142

108

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“…Detecting perineural invasion requires a high index of suspicion. 3 Factors associated with perineural spread include male gender, tumor size Ͼ 2 cm, location on the midface, and previous treatment of the lesion. 4 -6 Tumor spread usually is antegrade (toward the central nervous system), but retrograde spread also may occur.…”

Section: Discussionmentioning

confidence: 99%

Impact of radiographic findings on prognosis for skin carcinoma with clinical perineural invasion

Galloway

Morris

Mancuso

et al. 2005

Cancer

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Background The nuclear weapons industry has long been known as a source of beryllium exposure. Methods A total of 1,004 former workers from a nuclear weapons assembly site in the Midwest were screened for sensitization to beryllium (BeS). The screenings were part of the Department of Energy (DOE) Former Worker Program established in 1996. Results Twenty‐three (2.3%) workers were found sensitized to beryllium and this prevalence was comparable to other DOE sites. Occasional, direct exposure to beryllium through machining and grinding of copper–beryllium (Cu–Be) 2% alloy tools was found to increase the risk of sensitization compared to background exposure (OR = 3.83; 95% CI: 1.04–14.03) with a statistically significant trend (P = 0.03) revealing that particular jobs are associated with sensitization. Exposure potential in this study was estimated based on job titles and not personal exposure information. Conclusions These results confirm the need to screen workers using beryllium alloy tools in other industries and for consideration of altering work practices. Am. J. Ind. Med. 54:194–204, 2011. © 2010 Wiley‐Liss, Inc.

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Multiple Cranial Neuropathies Evolving Over a Decade From Occult Perineural Basal Cell Carcinoma

Fletcher¹

2012

Arch Neurol

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Skin cancer of the head and neck with clinical perineural invasion

Cited by 144 publications

References 12 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?

Impact of radiographic findings on prognosis for skin carcinoma with clinical perineural invasion

Multiple Cranial Neuropathies Evolving Over a Decade From Occult Perineural Basal Cell Carcinoma

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