Defining incidental perineural invasion: the need for a national registry

Buchanan, Lauren, De'Ambrosis, Brian, De'Ambrosis, Kathryn, Warren, Timothy, Huilgol, Shyamala, Soyer, H. Peter and Panizza, Benedict (2013) Defining incidental perineural invasion: the need for a national registry. Australasian Journal of Dermatology, 55 2: 107-110. doi:10.1111/ajd.12129

Author Buchanan, Lauren
De'Ambrosis, Brian
De'Ambrosis, Kathryn
Warren, Timothy
Huilgol, Shyamala
Soyer, H. Peter
Panizza, Benedict
Title Defining incidental perineural invasion: the need for a national registry
Journal name Australasian Journal of Dermatology   Check publisher's open access policy
ISSN 0004-8380
Publication date 2013-12-23
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1111/ajd.12129
Open Access Status Not yet assessed
Volume 55
Issue 2
Start page 107
End page 110
Total pages 4
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell
Language eng
Abstract This article by the Perineural Invasion (PNI) Registry Group aims to clarify clinical and histopathological ambiguities surrounding PNI in non-melanoma skin cancer (NMSC). PNI is reportedly present in approximately 2–6% of cases of NMSC and is associated with greater rates of morbidity and mortality. The distinction between clinical PNI and incidental PNI is somewhat unclear, especially in regard to management and prognosis. One important objective of the PNI Registry is to develop a standardised method of classifying perineural invasion. Hence, in this article we propose a definition for PNI and for its sub-classification. This article also provides a critical analysis of the current literature on the treatment of incidental PNI by evaluating the key cohort studies that have investigated the use of surgery or radiotherapy in the management of incidental PNI. At present, there are no universal clinical guidelines that specify the acceptable treatment of NMSC exhibiting incidental PNI. Consequently, patients often receive surgery with varying wider margins, or radiotherapy despite the limited evidence substantiating such management options. It is evident from the existing literature that current opinion is divided over the benefit of adjuvant radiotherapy. Certain prognostic factors have been proposed, such as the size and depth of tumour invasion, nerve diameter, the presence of multifocal PNI and the type of tumour. The PNI Registry is a web-based registry that has been developed to assist in attaining further data pertaining to incidental PNI in NMSC. It is envisaged that this information will provide the foundation for identifying and defining best practice in managing incidental PNI.
Keyword Incidental perineural invasion
Non-melanoma skin cancer
Perineural invasion
Skin cancer
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 23 December 2013.

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2014 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 7 times in Thomson Reuters Web of Science Article | Citations
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Created: Sat, 25 Jan 2014, 23:19:24 EST by Dr Benedict Panizza on behalf of Surgery - Princess Alexandra Hospital