Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
Oral and Maxillofacial SurgeryPrognostic significance of perineural invasion in oral and oropharyngeal carcinoma
Section snippets
Materials and methods
One hundred one patients with previously untreated SCC of the oral cavity and oropharynx who were treated surgically at the First Department of Oral and Maxillofacial Surgery, Niigata University, were the subjects of this study. Patients with unresectable tumors at diagnosis and those refusing surgery were excluded from this study. There were 64 male and 37 female patients, with an average age of 60 years (range 26-86 years). The anatomic site of the primary tumor was the oral cavity in 91
Results
Twenty-nine (28.7%) patients had a recurrence or metastases, including 8 patients with recurrence at the primary site, 14 patients with metastases in the neck, and 7 patients with distant metastases. Seventy-five percent of them occurred within 1 year and 92% within 2 years after the initial treatment. Secondary surgery or irradiations were performed for 2 local and twelve neck lesions. One patient with local recurrence and 7 patients with neck recurrence were salvaged successfully with the
Discussion
Perineural spaces are well recognized routes for the extension of tumors of various histologic types arising in the head and neck region.8., 12., 13., 14., 15., 16. In the literature, the occurrence of PNI from carcinomas of the head and neck is reported to range from 6% to 30%,4., 6., 16., 17. similar to the 25.7% rate in the present study. According to the results of our study, PNI is associated with tumor thickness, differentiation, and lymph node metastasis and is an important predictor of
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