Is Perineural Invasion a Novel Prognostic Factor Useful to Tailor Adjuvant Treatment in Patients Treated With Primary Surgery for Cervical and Vulvar Carcinoma?

Abstract

Perineural invasion (PNI) is detected in 7.0-35.1% of cervical carcinomas. This histological finding correlates with cervical invasion, lymph-vascular space invasion (LVSI), tumor size, positive resection margins, parametrial invasion, node metastases and advanced stage. Some authors have reported that PNI has no prognostic relevance, others have found that PNI is related to disease-free survival or overall survival (OS) at univariate analysis, and others have observed that it is an independent poor prognostic factor for OS. The evaluation of PNI status should be included in the decisionmaking process for planning adjuvant treatment. PNI has been found in 7.6-52.4% of vulvar carcinomas. This feature, which is strongly associated with depth of invasion, LVSI, tumor size, advanced stage and nodal involvement, is an independent prognostic variable for the risk of recurrence and death in most series. PNI should be evaluated routinely in histopathology reports of vulvar carcinoma and could help clinicians to tailor adjuvant treatment.

Prognostic Value of Perineural Invasion in Oral Tongue Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

“…PNI results from the complex interaction between invading tumor cells and the particular perineural niche (8)(9)(10)(11). PNI is defined by tumor cells invading perineural tissues, tracking along nerves; since nerves travels across a wide number of structures in the head and neck area, the tumor cells can invade a large area (12,13).…”

“…PNI has been reported to be associated with cancer outcomes in various types of cancer ( 8 – 11 ), including HNSCC ( 19 – 21 ) and OTSCC ( 20 , 27 , 28 , 30 , 43 , 48 , 50 ), but the findings in OTSCC are not unanimous ( 25 , 26 , 31 , 32 , 44 , 46 ). Nevertheless, when synthesized using the meta-analysis methodology, these conflicting studies support that PNI is associated with locoregional recurrence and poor OS, DFS, and CSS.…”

“…Perineural invasion (PNI) is the result of a complex interaction between invading tumor cells and the particular perineural niche, which has been noted to affect outcomes in many cancers (8)(9)(10)(11). PNI is observed in 70%-100% of pancreatic cancers, 7%-76% of gastric cancers, 56%-88% of biliary tract tumors, 12%-84% of prostate cancers, 5%-90% of head and neck cancers, 16%-39% of colorectal cancers, and 9%-31% of cervical cancers (8).…”

Sleep Disorders Prior to Adjuvant Radiation Therapy for Gynecological Malignancies

“…Many patients with gynecological cancer receive radiotherapy and/or chemotherapy, which can cause sleep disorders due to fear and nervousness (9)(10)(11). The prevalence of sleep disorders in patients with gynecological malignances reported in the literature ranged between 25% and 68% (4,5,(12)(13)(14).…”

Superficially Invasive Vulvar Squamous Cell Carcinoma: A 37-Year-Long Experience of a Tertiary Referral Center

“…PNI is a pathological feature that is not taken into account by FIGO staging, although the pathologist commonly reports it if present [53]. PNI has been associated with tumor recurrence and worse outcomes in many solid tumors including prostate, head and neck, colorectal, and gastric cancer [19].…”