Saipooja R H, Mishra Niranjan, Deepak Kumar Chandrasekaran, Mohanty Yangyasmit, Pati Debashish, Mishra Abhipsa
Department of Oral and Maxillofacial Surgery, S.C.B. Dental College and Hospital, Cuttack, Odisha 753007 India.
Department of Anaesthesiology, S.C.B. Medical College and Hospital, Cuttack, Odisha India.
J Maxillofac Oral Surg. 2024 Aug;23(4):864-872. doi: 10.1007/s12663-024-02172-x. Epub 2024 Apr 10.
The purpose of this study was to analyse the independent prognostic significance of perineural invasion (PNI) on local recurrence (LR) in patients with oral squamous cell carcinoma (OSCC) managed primarily with surgery.
Clinical and histopathological data of 195 patients with OSCC were analysed retrospectively to identify risk factors associated with PNI and to evaluate its significant correlation with local recurrence, overall survival (OS) and recurrence free survival (RFS).
Patients were followed for a mean period of 39.5 ± 1.376 months and median 35 months. PNI was found in 57 patients (29.2%). PNI correlated with tongue subsite ( = 0.001), nodal metastasis ( < 0.000), depth of invasion (DOI) ( = 0.002), stage ( = 0.013) and adjuvant therapy ( < 0.001). Mean time to recurrence with PNI was significantly shorter ( = 0.002).Multivariate analysis did not establish significant relationship between PNI and LR. Kaplan-Meier curve did not show statistical significance with OS ( = 0.085) or RFS ( = 0.110).
PNI remains an aggressive factor for nodal metastasis mandating neck management for regional control. Though PNI showed no statistical significance with LR, time to recurrence in PNI positive patients were significantly shorter. Hence, close follow-up regimen becomes necessary.
本研究旨在分析在主要接受手术治疗的口腔鳞状细胞癌（OSCC）患者中，神经周围侵犯（PNI）对局部复发（LR）的独立预后意义。
回顾性分析195例OSCC患者的临床和组织病理学数据，以确定与PNI相关的危险因素，并评估其与局部复发、总生存期（OS）和无复发生存期（RFS）的显著相关性。
患者平均随访39.5±1.376个月，中位随访时间为35个月。57例患者（29.2%）发现有PNI。PNI与舌亚部位（=0.001）、淋巴结转移（<0.000）、浸润深度（DOI）（=0.002）、分期（=0.013）及辅助治疗（<0.001）相关。PNI患者的平均复发时间明显更短（=0.002）。多因素分析未显示PNI与LR之间存在显著关系。Kaplan-Meier曲线显示PNI与OS（=0.085）或RFS（=0.110）无统计学意义。
PNI仍然是淋巴结转移的一个侵袭性因素，需要进行颈部处理以实现区域控制。虽然PNI与LR无统计学意义，但PNI阳性患者的复发时间明显更短。因此，密切的随访方案变得必要。
