Mesolella Massimo, Iorio Brigida, Misso Gabriella, Luce Amalia, Cimmino Mariano, Iengo Maurizio, Landi Mario, Sperlongano Pasquale, Caraglia Michele, Ricciardiello Filippo
Department of Neurosciences, Ear, Nose and Throat Section, University of Naples 'Federico II', Naples I-80138, Italy.
Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples I-80138, Italy.
Oncol Lett. 2016 Apr;11(4):2595-2598. doi: 10.3892/ol.2016.4265. Epub 2016 Feb 24.
The diffusion of laryngeal cancer cells in the perineural space is a parameter associated with a negative prognosis, high loco-regional recurrence and low disease-free survival rates. The spread of tumor cells on the perineural sheath highlights the histopathological and clinically aggressive behavior of this type of tumor, which may extend proximally or distally in the nerve for >10 cm. Therefore, the surgical resection margin is generally insufficient to treat patients with laryngeal cancer presenting with perineural invasion (PNI) with surgery alone. In PNI, the minor laryngeal nerves are frequently involved, rather than the superior and inferior laryngeal nerves. The aim of the present study was: i) To evaluate the prognostic importance of PNI; ii) to correlate the rate of infiltration with factors associated with the tumor, including histotype, site and tumor-node-metastasis stage, and with the type of surgery (total or partial laryngectomy); and iii) to evaluate the rate of disease-free survival according to the outcome of combined surgery and radiotherapy (RT) treatment, by means of retrospective analysis. The results of the present study highlighted the importance of performing a closer clinical and instrumental follow-up in patients with laryngeal cancer whose histopathological examination is positive for PNI. In such cases, it is important to complement the surgical therapeutic treatment with adjuvant RT.
喉癌细胞在神经周间隙的扩散是一个与预后不良、局部区域高复发率和低无病生存率相关的参数。肿瘤细胞在神经周鞘上的扩散突出了这类肿瘤的组织病理学和临床侵袭性行为，其可在神经内近端或远端延伸超过10 cm。因此，手术切缘通常不足以单独通过手术治疗伴有神经周浸润（PNI）的喉癌患者。在PNI中，受累的常常是喉的小神经，而非喉上神经和喉下神经。本研究的目的是：i）评估PNI的预后重要性；ii）将浸润率与肿瘤相关因素（包括组织类型、部位和肿瘤-淋巴结-转移分期）以及手术类型（全喉或部分喉切除术）相关联；iii）通过回顾性分析，根据手术联合放疗（RT）治疗的结果评估无病生存率。本研究结果突出了对组织病理学检查PNI呈阳性的喉癌患者进行更密切的临床和器械随访的重要性。在这种情况下，用辅助性RT补充手术治疗很重要。
