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Is Perineural Invasion an Independent Prognostic Factor for Local Recurrence in Oral Squamous Cell Carcinoma?

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Abstract

Purpose

The purpose of this study was to analyse the independent prognostic significance of perineural invasion (PNI) on local recurrence (LR) in patients with oral squamous cell carcinoma (OSCC) managed primarily with surgery.

Subjects and Methods

Clinical and histopathological data of 195 patients with OSCC were analysed retrospectively to identify risk factors associated with PNI and to evaluate its significant correlation with local recurrence, overall survival (OS) and recurrence free survival (RFS).

Results

Patients were followed for a mean period of 39.5 ± 1.376 months and median 35 months. PNI was found in 57 patients (29.2%). PNI correlated with tongue subsite (p = 0.001), nodal metastasis (p < 0.000), depth of invasion (DOI) (p = 0.002), stage (p = 0.013) and adjuvant therapy (p < 0.001). Mean time to recurrence with PNI was significantly shorter (p = 0.002).Multivariate analysis did not establish significant relationship between PNI and LR. Kaplan–Meier curve did not show statistical significance with OS (p = 0.085) or RFS (p = 0.110).

Conclusion

PNI remains an aggressive factor for nodal metastasis mandating neck management for regional control. Though PNI showed no statistical significance with LR, time to recurrence in PNI positive patients were significantly shorter. Hence, close follow-up regimen becomes necessary.

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Funding

This research did not receive any specific form of grant from funding agencies in the public, commercial or non-profit sectors.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, S.C.B. Dental College and Hospital, Cuttack, Odisha, 753007, India

    R. H. Saipooja, Niranjan Mishra, Chandrasekaran Deepak Kumar, Debashish Pati & Abhipsa Mishra

  2. Department of Anaesthesiology, S.C.B. Medical College and Hospital, Cuttack, Odisha, India

    Yangyasmit Mohanty

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  1. R. H. Saipooja
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  2. Niranjan Mishra
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  3. Chandrasekaran Deepak Kumar
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  6. Abhipsa Mishra
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Contributions

Study concept and design done by NM and SRH. Material preparation, data collection and analysis done by SRH and DKC. The first draft of manuscript was written by SRH. Manuscript editing done by DP and AM. Manuscript review done by NM and YM. All authors read and approved the final manuscript.

Corresponding author

Correspondence to R. H. Saipooja.

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Conflicts of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical Approval

This retrospective study was performed according to the Declaration of Helsinki and was approved by the Institutional Ethics Committee (Regd. No. IEC/SCBDCH/031/2019).

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All the participants of this study have signed an informed consent agreement.

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Saipooja, R.H., Mishra, N., Deepak Kumar, C. et al. Is Perineural Invasion an Independent Prognostic Factor for Local Recurrence in Oral Squamous Cell Carcinoma?. J. Maxillofac. Oral Surg. (2024). https://doi.org/10.1007/s12663-024-02172-x

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