Prognostic Impact of Perineural Invasion in Cutaneous Squamous Cell Carcinoma: Results of a Prospective Study of 1,399 Tumors

Haug, K.; Breuninger, Helmut; Metzler, Gisela; Eigentler, Thomas; Eichner, Martin; Häfner, Hans‐Martin; Schnabl, Saskia Maria

doi:10.1016/j.jid.2020.01.035

Cited by 36 publications

(36 citation statements)

References 31 publications

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“…Many of the present patients with PNI had late lymph node metastasis (p = 0.012). Lymph node metastasis was observed in another study including patients with PNI, and the patients' prognoses were poor; 34 we obtained a similar result. We observed that by combining the present of PNI and the MOI, there were very few cases of late lymph node metastasis among the patients with MOI type 4D or PNI (p=0.002), and the combination provided 55.6% sensitivity, 93.8% speci city, the positive predictive value 83.3%, and the negative predictive value 79.0%.…”

Section: Discussionsupporting

confidence: 84%

The Pattern and Spread of Invasion Can Predict Late Cervical Lymph Node Metastasis in Early Tongue Squamous Cell Carcinoma

Kato¹,

Miyazawa²,

Kobayashi³

et al. 2021

COO

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To determine the predictive indexes of late cervical lymph node metastasis in early tongue squamous cell carcinoma (TSCC). We retrospectively analyzed the cases of 25 patients with stage I/II TSCC who had undergone surgical treatment without elective neck dissection. We evaluated the relationships between clinicopathologic factors and the occurrence of late cervical lymph node metastasis. Of the 25 cases, metastasis to the cervical lymph nodes was observed in nine cases (36.0%). The clinicopathological factors associated with late cervical lymph node metastasis were the mode of invasion (MOI, p=0.032), depth of invasion (DOI, p=0.004), and perineural invasion (PNI, p=0.040). A multivariate analysis revealed that only the DOI was an independent predictor of late cervical lymph node metastasis. The combination of the DOI and MOI or the PNI and MOI was signi cantly correlated with late cervical lymph node metastasis (p=0.004 and p=0.012, respectively). Our ndings suggest that combinations of the MOI, DOI, and PNI could be used as an index for predicting late cervical lymph node metastasis in early TSCC.

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Section: Discussionsupporting

confidence: 84%

The Pattern and Spread of Invasion Can Predict Late Cervical Lymph Node Metastasis in Early Tongue Squamous Cell Carcinoma

Kato¹,

Miyazawa²,

Kobayashi³

et al. 2021

COO

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“…Keratinocyte cancers (KCs) are the most common cancers worldwide, with the head and neck the most common site in up to 85% of cases 1 . In cutaneous squamous cell carcinoma (cSCC), perineural invasion (PNI) is well established as an independent high‐risk factor and is associated with poor outcomes 2,3 . Perineural spread (PNS), different from incidentally detected PNI, presents with signs and symptoms of cranial nerve neuropathy and/or radiological diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Immunotherapy for the treatment of perineural spread in cutaneous head and neck squamous cell carcinoma: Time to rethink treatment paradigms

et al. 2022

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Background Immune checkpoint inhibitors have shown promising antitumour activity. Application in head and neck cutaneous squamous cell carcinoma (cSCC) large nerve perineural spread (PNS) is limited. Methods Retrospective review of 13 patients with PNS receiving anti‐PD‐1 therapy from September 2017 to May 2021 is presented. Primary endpoints were objective response (complete or partial response) and median time to progression, determined by Head and Neck Multi‐Disciplinary Team (MDT) and independent radiology review of magnetic resonance imaging (MRI) and/or computed tomography/positron emission tomography (CT/PET). Results Objective response was observed in 9/13 patients (69%), with complete response in 6 (46%) and partial response in 3 patients (23%). Median time to response was 2.1 months (IQR 1.8–2.7 months). There were 3 (23%) patients with progressive disease, with median time to progression of 3.5 months. There were no grade 3–4 treatment related adverse events. Conclusions This case series supports developing evidence for anti‐PD‐1 checkpoint inhibitor therapy for perineural spread, supporting future prospective clinical trials in this patient population.

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“…High association with PNI is described, which is also a sign of high malignancy and a high risk of tumor-specific death. 6,8,15,16,27 As the results of this study show, the special local tumor infiltration of dSCC with widespread tumor growth caused by fine, frequently single-cell layer tumor strands lead to significant increased re-excisions (70.0% vs 23.9%, p , .001), recurrence (26.7% vs 5.0%, p , .001), and metastasis rates (16.6% vs 2.3%, p , .001). Often dSCC cannot be detected by routine histologic monitoring of surgical margins.…”

Section: Discussionmentioning

confidence: 81%

“…3,4 Previous investigations showed a significant influence of the desmoplastic subtype of SCC (dSCC). 3,[5][6][7][8][9] However, the role of dSCC is indistinct in the literature. Often, it seems only to be referred as dedifferentiation, and no consistent terminology is used.…”

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confidence: 99%

Local Tumor Infiltration and Locoregional Recurrence in Desmoplastic Cutaneous Squamous Cell Carcinoma

et al. 2021

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BACKGROUND Perusal of the literature of cutaneous squamous cell carcinoma (SCC) reveals that the role of the desmoplastic subtype is indistinct. Data on local infiltration and recurrence are inconsistent dependent on surgical technique, histological method, and investigated collective. OBJECTIVE The aim of the study was to analyze local infiltration and locoregional recurrence of the desmoplastic subtype under a uniform procedure. METHODS AND MATERIALS Between 2005 and 2015, 320 SCCs were analyzed and histological sections of all tumors were examined. Data collection included locoregional recurrence, metastasis rate, and tumor-specific death. The median follow-up was 36.5 months. RESULTS The desmoplastic subtype required significant more re-excisions (70.0% vs 23.9%, p , .001), more interventions until tumor-free margins were achieved (maximal 6 vs 2; p , .001), showed more widespread tumor infiltration with larger excisional margins (median 9 mm, 2-51 mm vs median 4 mm, 1-10 mm; p , .001), and a 5-fold higher local recurrence rate (26.7% vs 5.0%, p , .001). The metastasis rate (16.6% vs 2.3%, p , .001) was increased. CONCLUSION The desmoplastic subtype is characterized by a widespread local infiltration associated with perineural infiltration. It seems to be a marker for decreased histological detectability with a high rate of locoregional recurrence and metastasis.

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Prognostic Impact of Perineural Invasion in Cutaneous Squamous Cell Carcinoma: Results of a Prospective Study of 1,399 Tumors

Cited by 36 publications

References 31 publications

The Pattern and Spread of Invasion Can Predict Late Cervical Lymph Node Metastasis in Early Tongue Squamous Cell Carcinoma

The Pattern and Spread of Invasion Can Predict Late Cervical Lymph Node Metastasis in Early Tongue Squamous Cell Carcinoma

Immunotherapy for the treatment of perineural spread in cutaneous head and neck squamous cell carcinoma: Time to rethink treatment paradigms

Local Tumor Infiltration and Locoregional Recurrence in Desmoplastic Cutaneous Squamous Cell Carcinoma

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