Epidemiology of clinical perineural invasion in cutaneous squamous cell carcinoma of the head and neck

Solares, C. Arturo, Lee, Ken, Parmar, Priya, O'Rourke, Peter and Panizza, Benedict (2012) Epidemiology of clinical perineural invasion in cutaneous squamous cell carcinoma of the head and neck. Otolaryngology - Head and Neck Surgery, 146 5: 746-751.


Author Solares, C. Arturo
Lee, Ken
Parmar, Priya
O'Rourke, Peter
Panizza, Benedict
Title Epidemiology of clinical perineural invasion in cutaneous squamous cell carcinoma of the head and neck
Journal name Otolaryngology - Head and Neck Surgery   Check publisher's open access policy
ISSN 0194-5998
1097-6817
Publication date 2012-05
Sub-type Article (original research)
DOI 10.1177/0194599811434897
Volume 146
Issue 5
Start page 746
End page 751
Total pages 6
Place of publication Thousand Oaks CA, United States
Publisher Sage Publications
Collection year 2013
Language eng
Formatted abstract Background. Perineural invasion (PNI) in cutaneous squamous cell carcinoma of the head and neck (CSCCHN) is associated with decreased survival. Large-nerve PNI presents with clinical signs and symptoms and/or magnetic resonance imaging evidence of cranial nerve involvement. We sought to determine which variables predict a worse outcome and to analyze patterns of failure.

Study Design. Case series with planned data collection.

Setting. Tertiary care center.

Subjects and Methods. Patients with large-nerve PNI from CSCCHN between 1996 and 2006 were identified from a prospectively collected database. Clinical and demographic variables were recorded. Local control rates and survival analysis were performed using Kaplan-Meier curves.

Results
. Thirty-six patients were identified (28 men and 8 women). The mean age was 61 years. Twenty-nine were treated with curative intent, and 7 received palliation. The mean follow-up was 35 months. Involvement of V3, disease zone, and the type of therapy were significantly associated with overall survival (P < .05). The 5-year disease-free survival for patients by therapy was 50% for subcranial surgeries, 53.6% for skull base surgery, and 0% for radiation and palliative therapies (P < .001). None of the patients treated with a skull base resection had a central recurrence, while all patients who received palliation had a central failure.

Conclusions. Disease extent, type of therapy, and involvement of V3 are all significant predictors of survival in PNI from CSCCHN. We confirmed that the natural history of the disease is central progression and that this can be halted, if detected early enough, by a properly planned skull base resection.
Keyword Perineural spread
Cutaneous squamous cell carcinoma
Basal cell carcinoma
Skull base surgery
Radiation therapy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 4 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 5 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Access Statistics: 35 Abstract Views  -  Detailed Statistics
Created: Mon, 28 May 2012, 23:01:05 EST by System User on behalf of School of Medicine