Santoro Angela, Angelico Giuseppe, Travaglino Antonio, Inzani Frediano, Arciuolo Damiano, Valente Michele, D'Alessandris Nicoletta, Scaglione Giulia, Piermattei Alessia, Cianfrini Federica, Straccia Patrizia, Benvenuto Roberta, Raffone Antonio, Garganese Giorgia, Gallotta Valerio, Zannoni Gian Franco
Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze Della Salute Della Donna, Del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Roma, Italy.
Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138, Bologna, Italy.
Eur J Surg Oncol. 2022 Dec;48(12):2354-2359. doi: 10.1016/j.ejso.2022.06.031. Epub 2022 Jun 25.
The prognostic role of perineural invasion (PNI) in vulvar squamous cell carcinoma (VSCC) has not been fully established since few studies on this topic are currently available in the literature. In the present study, we conducted a systematic review and metanalysis of literature data in order to determine if PNI could be an independent prognostic predictor of patient's survival in VSCC. Four electronic databases (PubMed, ISI Web of Science, Scopus and Google Scholar) were searched from their inception to December 2021 for all studies assessing the prognostic value of PNI in VSCC. Multivariate hazard ratios (HRs) for overall survival (OS), disease-specific survival (DSS), and progression-free survival (PFS) were pooled. Six studies with 1048 patients were included. PNI was significantly associated with decreased OS (HR = 2.687; p < 0.001), DSS (HR = 2.375; p = 0.014) and PFS (HR = 1.757; p = 0.001), with no statistical heterogeneity among studies and no significant risk of bias across studies. The present meta-analysis highlights that PNI is independently associated with unfavorable prognosis in patients with VSCC. Therefore, PNI should be included in the pathological report of VSCC and considered in combination with other risk factors as a possible criteria for prognostic assessment adjuvant treatment planning inclusion.
由于目前文献中关于外阴鳞状细胞癌（VSCC）中神经周围浸润（PNI）的预后作用的研究较少，其尚未完全明确。在本研究中，我们对文献数据进行了系统回顾和荟萃分析，以确定PNI是否可能是VSCC患者生存的独立预后预测指标。检索了四个电子数据库（PubMed、ISI Web of Science、Scopus和谷歌学术），从其创建到2021年12月，查找所有评估PNI在VSCC中预后价值的研究。汇总了总生存期（OS）、疾病特异性生存期（DSS）和无进展生存期（PFS）的多变量风险比（HRs）。纳入了六项研究，共1048例患者。PNI与OS降低（HR = 2.687；p < 0.001）、DSS降低（HR = 2.375；p = 0.014）和PFS降低（HR = 1.757；p = 0.001）显著相关，研究间无统计学异质性，且各研究无显著偏倚风险。本荟萃分析强调，PNI与VSCC患者的不良预后独立相关。因此，PNI应纳入VSCC的病理报告中，并与其他风险因素结合考虑，作为预后评估辅助治疗计划纳入的可能标准。
