Prognostic significance of the neural invasion in oral squamous cell carcinoma
|Author:||da Dolens, Eder Silva1,2; de Morais, Everton Freitas3; Paranaíba, Lívia Máris Ribeiro4;|
1Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba, Brazil
2University of Western Paulista (UNOESTE), Presidente Prudente, Brazil
3Department of Oral Diagnosis, School of Dentistry, University of Campinas, Piracicaba, Brazil
4Department of Pathology and Parasitology, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, Brazil
5Department of Oral Pathology and Oral Medicine, Dental School, State University of Western Parana, Cascavel, Brazil
6Department of Pathology, University of Turku, Turku, Finland
7Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
8Research Unit of Popular Health, University of Oulu and Oulu University Hospital, Oulu, Finland
9Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2023070690317
John Wiley & Sons,
|Publish Date:|| 2024-02-27
Background: Although nerve involvement can predict recurrence and prognosis in oral squamous cell carcinomas, there still have controversies and limitations regarding the standardization for its detection. In this study, we explore the impact of neural invasion in oral squamous cell carcinomas prognosis, comparing intraneural invasion (tumor cells inside nerve structure) and perineural invasion (cells involving the nerve, but not invading its sheath).
Methods: Surgical slides stained with hematoxylin and eosin from 235 patients with oral squamous cell carcinomas were carefully verified for the presence of intraneural invasion and perineural invasion. The location in the tumor (intratumoral vs. peritumoral) and number of foci (unifocal or multifocal) were also explored. Survival analyses for cancer-specific survival and disease-free survival were performed with Cox proportional model.
Results: Neural invasion was identified in 74 cases, 64.9% displayed intraneural invasion and 35.1% displayed perineural invasion. Univariate analysis revealed a significantly poorer cancer-specific survival, but not disease-free survival, in patients with intraneural invasion, in contrast to cases with perineural invasion that did not achieve significant association with both cancer-specific survival and disease-free survival. Further analyses revealed that the location in the tumor and number of foci had little impact on discriminatory ability of intraneural invasion. Multivariate analysis confirmed that intraneural invasion is significantly and independently associated with poor cancer-specific survival (hazard ratio: 2.50, 95% CI: 1.31–3.79, p = 0.003).
Conclusions: This study provides evidence that intraneural invasion, but not perineural invasion, is a relevant predictor of survival in patients with oral squamous cell carcinomas, suggesting that its association with other clinical and pathological prognostic factors should be consider in determining the optimal treatment protocol and prognosis of these patients.
Journal of oral pathology & medicine
|Pages:||476 - 482|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), Grant/Award Numbers: 2022/00994-5, 2018/16077-6; Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Grant/Award Number: 303589/2019-1; Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG), Grant/Award Number: PPM-00179-18.
© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. This is the peer reviewed version of the following article: da Dolens, ES, de Morais, EF, Paranaíba, LMR, et al. Prognostic significance of the neural invasion in oral squamous cell carcinoma. J Oral Pathol Med. 2023; 1-7. doi:10.1111/jop.13423, which has been published in final form at https://doi.org/10.1111/jop.13423. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.