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Factors predicting the perineural invasion in carcinoma oral cavity
Dipti R Samanta1, Senapati Surendra2, K Rout Suresh2, Avinash Ajitesh2, Parida Maitree2, K Dash Tapas2, K Bhuyan Sanat3, N Mallik Rabi4
1 Department of Medical Oncology, Acharya Harihar Post Graduate Institute of Cancer, Cuttack, India
2 Department of Radiation Oncology, Acharya Harihar Post Graduate Institute of Cancer, Cuttack, India
3 Department of Oral Medicine and Radiology, Institute of Dental Sciences, Bhubaneshwar, Odisha, India
4 Department of Pathology, Kalinga Institute of Medical Sciences, Bhubaneshwar, Odisha, India
Correspondence Address:
Avinash Ajitesh,
Sai Karuna, Surya Vihar, Link Road, Cuttack, Odisha
India
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/jcrt.JCRT_1455_21
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Objective: This study to evaluate clinicopathological parameters such as age, tumor location, tumor size, grade, depth of invasion (DOI), lymphovascular space invasion (LVSI), lymph node metastasis, and stage that predict peri-neural invasion (PNI) in oral squamous cell carcinoma (OSCC).
Material and Methods: A retrospective study on 1716 postoperative OSCC patients who satisfied the eligibility criteria and treated from January 2009 to December 2019 was analyzed using IBM SPSS V23. Mean and percentage were assessed using descriptive statistics. Wilcoxon–Mann–Whitney U-test was used to compare continuous variables, while Chi-square test was used to compare discrete variables between PNI-positive and PNI-negative groups. Two-tailed P < 0.05 was considered to be statistically significant.
Results: Out of 1716 patients, 553 were PNI positive. The mean age was 48.76 ± 12.42 years in PNI-positive patients while 51.52 ± 12.51 years in PNI-negative patients. Males outnumbered females. The most common primary was carcinoma buccal mucosa (204, 36.9%), followed by carcinoma of oral tongue (161,29.1%). Maximum tumor size was 3.14 ± 1.20 cm in PNI-positive patients whereas 2.78 ± 1.22 cm in PNI-negative patients. Sixty (10.84%) patients in PNI-positive group and 51 (4.38%) in PNI-negative group had LVSI positive. Lymph node involvement was observed in 305 (55.13%) patients in PNI-positive group whereas 358 (30.78%) patients in PNI-negative group. Maximum number 228 (41.3%) in PNI-positive patients were in Stage IVA disease.
Conclusion: PNI is one of the important adverse prognostic factors having a definite correlation with anatomical subsite, tumor size, grade, DOI, LVSI, lymph node involvement, and stage of the disease. PNI should be analyzed in postoperative histopathology report of OSCC that guides the clinician for adjuvant therapy.
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