Skin carcinoma of the head and neck with perineural invasion

Balamucki, Christopher J.; Mancuso, Anthony A.; Amdur, Robert J.; Kirwan, Jessica; Morris, Christopher G.; Flowers, Franklin P.; Stoer, Charles B.; Cognetta, Armand B.; Mendenhall, William M.

doi:10.1016/j.amjoto.2011.11.004

Cited by 101 publications

(168 citation statements)

References 30 publications

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“…Regional nodal disease occurs in approximately 10% (9-16%) of patients with perineural spread 4,20,21 and, likewise, nodal recurrence following treatment is also low. As such, our MRI protocol for surveillance includes a single coronal STIR (short tau inversion recovery) sequence of the neck to assess for nodal disease.…”

Section: Tumor Recurrencementioning

confidence: 99%

Postoperative Imaging and Surveillance in Large Nerve Perineural Spread

Sommerville

Gandhi

2016

J Neurol Surg B

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Section: Tumor Recurrencementioning

confidence: 99%

Postoperative Imaging and Surveillance in Large Nerve Perineural Spread

Sommerville

Gandhi

2016

J Neurol Surg B

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“…35 The rate of regional nodal metastases at presentation in patients with clinical PNI appears to be low, with reported rates between 0% and 16%. 13,125,126 In addition, the reported rate of distant metastases at presentation is also low between 0.08% and 0.5%. 44 Routine two-dimensional histological sections may not detect PNI in a given specimen due to the three-dimensional structure of tumour within a nerve.…”

Section: Immunosuppression and Sccmentioning

confidence: 99%

“…An estimation of disease frequency in reported series from specialised tertiary centres suggests on average between two and eight patients seek treatment annually in these centres. 13,46 There are limitations in the available literature relating to clinical PNI mainly due to variable terminology and the pooling in many case series of tumour types (i.e. BCC and SCC), treatment approaches (i.e.…”

Section: T4mentioning

confidence: 99%

“…11 The detection of PNI in cutaneous SCC is associated with more aggressive behaviour and a worse prognosis. [12][13][14][15][16][17][18][19][20] A recent systematic review and meta-analysis comprising 36 studies with 17,248 patients analysed the risk factors for poor outcomes with cutaneous SCC. 21 The presence of PNI was significantly associated with higher risk of recurrence (relative risk {RR} 4.30, 95% CI 2.8-6.6, p < 0.01), metastasis (RR 2.95, 95% CI 2.31-3.75, p < 0.01) and death from disease (RR 4.06, 95% CI 3.10-5.32, p < 0.01).…”

Section: Perineural Invasionmentioning

confidence: 99%

“…surgery alone, radiotherapy alone and surgery and radiotherapy) and PNI subtypes (incidental and clinical). 12,13,45,[47][48][49] This has led to outcome data with limited application and inherent difficulties in defining management guidelines.…”

Section: T4mentioning

confidence: 99%

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Epidemiological and molecular features of cutaneous squamous cell carcinoma with perineural spread

Warren¹

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Clinical and Incidental Perineural Invasion of Cutaneous Squamous Cell Carcinoma

et al. 2017

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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.

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Skin carcinoma of the head and neck with perineural invasion

Cited by 101 publications

References 30 publications

Postoperative Imaging and Surveillance in Large Nerve Perineural Spread

Postoperative Imaging and Surveillance in Large Nerve Perineural Spread

Epidemiological and molecular features of cutaneous squamous cell carcinoma with perineural spread

Clinical and Incidental Perineural Invasion of Cutaneous Squamous Cell Carcinoma

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