Multifocal perineural invasion is a better prognosticator than depth of invasion in oral squamous cell carcinoma
Multifocal perineural invasion is a better prognosticator than depth of invasion in oral squamous cell carcinoma
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DOI：
10.1002/hed.25940
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发表时间：
2019-09-05
影响因子：
2.9
通讯作者：
Clark, Jonathan
中科院分区：
文献类型：
--
作者：
Hasmat, Shaheen;Ebrahimi, Ardalan;Clark, Jonathan
目的比较单灶性和多灶性口腔鳞状细胞癌（OSCC）神经浸润（PNI）与浸润深度（DOI）和淋巴结浸润（ENE）的预后意义。材料与方法对1995年至2018年期间接受治疗的861例连续OSCC患者进行单变量和多变量分析，局部失败（LF）和疾病特异性死亡率（DSS）作为主要终点。结果在调整其他不良组织病理学因素和辅助治疗后，与DOI相比，多灶性PNI与LF（P = 0.01）和DSS（P = 0.02）的风险更高相关。多灶性PNI的效果与无ENE的淋巴结转移的效果相当（P = 0.02）。LF和DSS没有改善单灶或多灶PNI组内的辅助放疗管理。结论多灶性PNI与口腔鳞癌的死亡风险相关性高于DOI。其效果与淋巴结转移（无ENE）相当。
Objectives Prognostic significance of perineural invasion (PNI) in oral squamous cell carcinoma (OSCC) characterized as unifocal and multifocal was compared to depth of invasion (DOI) and extranodal extension (ENE). Materials and Methods Univariable and multivariable analyses of 861 consecutive patients with OSCC undergoing treatment between 1995 and 2018 were performed, with local failure (LF) and disease-specific mortality (DSS) as the primary endpoints. Results After adjusting for other adverse histopathological factors and adjuvant therapy, multifocal PNI was associated with a greater risk of LF (P = .01) and DSS (P = 0.02) compared to DOI. The effect of multifocal PNI was comparable to the effect of nodal metastases without ENE (P = 0.02). LF and DSS were not improved by the administration of adjuvant radiotherapy within unifocal or multifocal PNI groups. Conclusion Multifocal PNI is associated with a greater risk of death in OSCC than DOI. Its effect is comparable to that of nodal metastases (without ENE).