scholarly journals Perineural Invasion in Vulvar Squamous-Cell Carcinoma Is an Independent Risk Factor for Cancer-Specific Survival, but Not for Locoregional Recurrence: Results from a Single Tertiary Referral Center

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 124
Author(s):  
Leonardo Micheletti ◽  
Fulvio Borella ◽  
Mario Preti ◽  
Valentina Frau ◽  
Stefano Cosma ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Locoregional Recurrence ◽  
Perineural Invasion ◽  
Depth Of Invasion ◽  
Tumor Diameter ◽  
Vulvar Squamous Cell Carcinoma ◽  
Cancer Specific Survival ◽  
Tertiary Referral Center

The aims of this study were to assess the prevalence of perineural invasion (PNI) in vulvar squamous cell carcinoma (VSCC) and its prognostic role in locoregional recurrence (LRR) and cancer-specific survival (CSS). We performed a retrospective analysis of 223 consecutive stage IB–IIIC surgically treated VSCCs at S. Anna Hospital, University of Turin, from 2000 to 2019. We identified 133/223 (59.6%) patients with PNI-positive VSCCs. PNI was associated with aggressive biological features (i.e., advanced FIGO stage, larger tumor diameter, greater depth of invasion, a higher number of metastatic lymph nodes, and lymphovascular invasion) and shorter 5-year CSS (78% vs. 90%, log-rank p = 0.02) compared with PNI-negative VSCCs. Multivariate analysis showed that PNI (HR 2.99 CI 95% 1.17–7.63; p = 0.02) and the presence of tumor cells on pathological surgical margins (HR 3.13 CI 95% 1.37–7.13; p = 0.007) are independent prognostic factors for CSS. PNI does not appear to be related to LRR, but is an independent prognostic factor for worse survival outcomes. Future studies are necessary to explore the possible value of PNI in tailoring the choice of adjuvant treatment.

scholarly journals Superficially Invasive Vulvar Squamous Cell Carcinoma: A 37-Year-Long Experience of a Tertiary Referral Center

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3859
Author(s):  
Mario Preti ◽  
Fulvio Borella ◽  
Niccolò Gallio ◽  
Luca Bertero ◽  
Debra Sandra Heller ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Figo Stage ◽  
Depth Of Invasion ◽  
Vulvar Squamous Cell Carcinoma ◽  
Tertiary Referral Center ◽  
Younger Women ◽  
Pathological Characteristics ◽  
Long Term Prognosis

Superficially, invasive vulvar squamous cell carcinoma (SISCCA) (FIGO stage IA) is a rare subset of vulvar cancer defined as a single lesion measuring ≤2 cm with a depth of invasion of ≤1.0 mm. This is a retrospective study performed on 48 patients with SISCCA, surgically treated between 1981 and 2018 at the S. Anna Hospital, University of Turin, to evaluate pathological characteristics and prognosis of these tumors. Ten patients (21%) recurred: seven (14%) as SISCCA and three (7%) as deeply invasive carcinoma. One case with perineural invasion and groin node metastasis at recurrence. No patient had groin lymph node metastases at initial diagnosis. Site of SISCCA, type of surgery, status of surgical margins, and histopathological features did not differ between recurrent and non-recurrent patients. We observed a non-significant trend towards an increase of recurrences in younger women (median age: 63 years vs. 70 years, p = 0.09), while, surprisingly, smaller tumors (<12 mm) were significantly related to tumor relapse (p = 0.03). Overall, SISCCA has a good long-term prognosis, regardless of the pathological characteristics and the type of surgical treatment. We recommend close follow-up, especially for younger patients and for small tumors, due to the possibility of recurrence or re-occurrence even after years.

scholarly journals An alternative way to measure the depth of invasion of vulvar squamous cell carcinoma in relation to prognosis

2014 ◽  
Vol 28 (2) ◽  
pp. 295-302 ◽  
Author(s):  
Loes CG van den Einden ◽  
Leon FAG Massuger ◽  
Johanna K Jonkman ◽  
Peter Bult ◽  
Joanne A de Hullu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Depth Of Invasion ◽  
Vulvar Squamous Cell Carcinoma

Abstract number 7: Potential prognostic value of perineural invasion in vulvar squamous cell carcinoma

2014 ◽  
Vol 134 (2) ◽  
pp. 432
Author(s):  
A. Gehlot ◽  
M. Schlumbrecht ◽  
E. Holthoff ◽  
A. Burnett ◽  
S. Jeffus ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Prognostic Value ◽  
Perineural Invasion ◽  
Vulvar Squamous Cell Carcinoma

scholarly journals Molecular and Cellular Mechanisms of Perineural Invasion in Oral Squamous Cell Carcinoma: Potential Targets for Therapeutic Intervention

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6011
Author(s):  
Carly I. Misztal ◽  
Carlos Green ◽  
Christine Mei ◽  
Rita Bhatia ◽  
Jaylou M. Velez Torres ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Schwann Cells ◽  
Squamous Cell ◽  
Therapeutic Intervention ◽  
Locoregional Recurrence ◽  
Perineural Invasion ◽  
Cellular Mechanisms ◽  
Cancer Migration

The most common oral cavity cancer is squamous cell carcinoma (SCC), of which perineural invasion (PNI) is a significant prognostic factor associated with decreased survival and an increased rate of locoregional recurrence. In the classical theory of PNI, cancer was believed to invade nerves directly through the path of least resistance in the perineural space; however, more recent evidence suggests that PNI requires reciprocal signaling interactions between tumor cells and nerve components, particularly Schwann cells. Specifically, head and neck SCC can express neurotrophins and neurotrophin receptors that may contribute to cancer migration towards nerves, PNI, and neuritogenesis towards cancer. Through reciprocal signaling, recent studies also suggest that Schwann cells may play an important role in promoting PNI by migrating toward cancer cells, intercalating, and dispersing cancer, and facilitating cancer migration toward nerves. The interactions of neurotrophins with their high affinity receptors is a new area of interest in the development of pharmaceutical therapies for many types of cancer. In this comprehensive review, we discuss diagnosis and treatment of oral cavity SCC, how PNI affects locoregional recurrence and survival, and the impact of adjuvant therapies on tumors with PNI. We also describe the molecular and cellular mechanisms associated with PNI, including the expression of neurotrophins and their receptors, and highlight potential targets for therapeutic intervention for PNI in oral SCC.

scholarly journals Perineural Invasion in Oral Squamous Cell Carcinoma in Relation to Tumor Depth

2019 ◽  
Vol 31 (2) ◽  
pp. 1-6
Author(s):  
Farah S Rasheed ◽  
Bashar H Abdullah
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Perineural Invasion ◽  
Staging System ◽  
Depth Of Invasion ◽  
Tumor Depth ◽  
Size Category ◽  
Significant Difference

Background: The American Joint committee on Cancer in their 8th edition staging manual regarded perineural invasion as one of the most important prognostic factors for Lip and Oral Cavity Squamous Cell Carcinoma, it also incorporated tumor depth of invasion in defining tumor size category in the new staging system. This study was conducted to evaluate the frequency of perineural invasion in oral squamous cell carcinoma and the effect of approaching tumor depth in this process. Materials and Methods: fifty-four formalin fixed paraffin embedded tissue blocks of radical resections of Oral Squamous Cell Carcinoma were cut and stained with Hematoxylin and Eosin stain, then evaluated for perineural invasion, with estimation of tumor depth of invasion for each case. Results: Perineural invasion was found in twenty-two cases of the study sample. The diameter of the largest nerve bundle that showed perineural invasion was found to have a positive significant correlation with tumor depth of invasion (p=0.025). Perineural invasion status in terms of (present, absent) showed a significant difference with patients’ age (p=0.037), also showed a significant association with tumor site (p=0.004), however, this association was non-significant in regard to tumor grade and stage (p=0.848, p=0.520) respectively. Conclusion: The attacking potential of preceding tumor depth and those cancers affecting young individuals may be reflected by the presence of neural infiltration by tumor cells. Tongue resected tumors should be carefully inspected for this deceptive biological process.

scholarly journals Difference in Clinical Presentation and Their Significance in Oral Squamous Cell Carcinoma – a Retrospective Analysis

2022 ◽  
Author(s):  
Jeyashanth Riju ◽  
Amit Jiwan Tirkey ◽  
Malavika Babu ◽  
Ronald Anto ◽  
Amey Madhav Baitule ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Perineural Invasion ◽  
Clinical Presentation ◽  
Tongue Cancer ◽  
Clinical History ◽  
Depth Of Invasion ◽  
Advanced Stage

Abstract Oral squamous cell carcinoma(OSCC) involving tongue and buccoalveolar complex(BAC) behaves differently. Clinical features of the two subsites and their influence on pathological factors remain least analysed. Patients are divided into two groups i.e, tongue cancer and BAC cancer group, and various clinical parameters were compared. Among 474 patients 232 had tongue cancer and 242 had BAC cancer. 30% of patients with OSCC were asymptomatic at presentation except for the ulcer. Compared to tongue cancers, lesions confined to BAC presents at an advanced stage(p=0.006). Multivariate analysis showed that dysphagia in tongue cancer(p=0.020) and external swelling or lesion in BAC cancers(p=0.002) were significant predictors of an advanced stage of disease. On histopathology perineural invasion was significantly associated tongue(p=0.008) and BAC cancers(P=0.015). Among tongue cancers, those with pain and referred otalgia had a statistically significantly high depth of invasion(DOI), compared to those without pain (DOI – no pain 6.9mm, pain 9.9mm and referred otalgia 11.4mm). There is a delay in clinical presentation of OSCC. Among tongue cancers, clinical history of pain was significantly associated with depth of invasion and perineural invasion, the significance of which needs to be prospectively analysed. Clinical history in OSCC can be used as predicting factors for various pathological characters, which is subsite specific.

scholarly journals Prognostic Value of Perineural Invasion in Oral Tongue Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Jiajia Li ◽  
Shan Liu ◽  
Zhangao Li ◽  
Xinxin Han ◽  
Lin Que
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Locoregional Recurrence ◽  
Perineural Invasion ◽  
Early Stage ◽  
Tongue Squamous Cell Carcinoma ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Oral Tongue

ObjectivesA significant number of recently published research has outlined the contribution of perineural invasion (PNI) to clinical outcomes in oral tongue squamous cell carcinoma (OTSCC), but some results remain conflicting. This study aimed to determine whether patients with OTSCC with PNI have a worse prognosis than those without PNI.Materials and MethodsPubMed, Embase, and the Cochrane Library were queried for potentially eligible articles published up to December 2020. The primary outcomes were the hazard ratio (HR) for locoregional recurrence, overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS). The random-effect model was used in all analyses.ResultsSeventeen studies (4445 patients) were included. Using adjusted HRs, the presence of PNI was associated with a higher risk of locoregional recurrence (HR=1.73, 95%CI: 1.07-2.79, P=0.025, I2 = 33.1%, Pheterogeneity=0.224), worse OS (HR=1.94, 95%CI: 1.39-2.72, P&lt;0.001, I2 = 0.0%, Pheterogeneity=0.838), worse DFS (HR=2.13, 95%CI: 1.53-2.96, P&lt;0.001, I2 = 48.4%, Pheterogeneity=0.071), and worse CSS (HR=1.93, 95%CI: 1.40-2.65, P&lt;0.001, I2 = 25.5%, Pheterogeneity=0.251). PNI had an impact on locoregional recurrence in early-stage OTSCC but not in all stages, and on OS, DFS, and CSS in all-stage and early-stage OTSCC. The sensitivity analyses showed that the results were robust.ConclusionThe presence of PNI significantly affects the locoregional recurrence and survival outcomes among patients with OTSCC.

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