Michael Campoli1, David G Brodland2, John Zitelli2. 1. Fairview Medical Group, Minneapolis, Minnesota. Electronic address: mcampol1@fairview.org. 2. Zitelli and Brodland PC, Pittsburgh, Pennsylvania.
Abstract
BACKGROUND: The prognosis and management of incidental perineural invasion (PNI) in patients with cutaneous squamous cell carcinoma (CSCC) has not been well defined. OBJECTIVE: We sought to investigate the clinical, histologic, and treatment characteristics associated with incidental PNI, histologic PNI extending beyond the tumor bulk, in patients with CSCC. METHODS: We conducted a multicenter prospective analysis of patients with CSCC undergoing Mohs micrographic surgery. RESULTS: The incidence of PNI was 4.6% in 753 CSCC cases. PNI was significantly associated with tumors of the head and neck (P = .039), larger tumor diameter (P < .001), presence of clinically palpable lymphadenopathy (P = .012), and recurrent (P < .001) and painful (P < .001) tumors. Further, PNI was significantly associated with poor tumor differentiation (P < .001), greater tumor thickness (P < .001), a greater number of Mohs stages (P < .001), and larger estimated maximum Mohs margin (P < .001) required to clear the tumor. LIMITATIONS: The low numbers of patients demonstrating incidental PNI limits this study. CONCLUSIONS: The association of incidental PNI with clinicopathological indicators of poor prognosis suggests that incidental PNI may serve as a marker to improve the precision in the prognostic assessment of patients with CSCC.
BACKGROUND: The prognosis and management of incidental perineural invasion (PNI) in patients with cutaneous squamous cell carcinoma (CSCC) has not been well defined. OBJECTIVE: We sought to investigate the clinical, histologic, and treatment characteristics associated with incidental PNI, histologic PNI extending beyond the tumor bulk, in patients with CSCC. METHODS: We conducted a multicenter prospective analysis of patients with CSCC undergoing Mohs micrographic surgery. RESULTS: The incidence of PNI was 4.6% in 753 CSCC cases. PNI was significantly associated with tumors of the head and neck (P = .039), larger tumor diameter (P < .001), presence of clinically palpable lymphadenopathy (P = .012), and recurrent (P < .001) and painful (P < .001) tumors. Further, PNI was significantly associated with poor tumor differentiation (P < .001), greater tumor thickness (P < .001), a greater number of Mohs stages (P < .001), and larger estimated maximum Mohs margin (P < .001) required to clear the tumor. LIMITATIONS: The low numbers of patients demonstrating incidental PNI limits this study. CONCLUSIONS: The association of incidental PNI with clinicopathological indicators of poor prognosis suggests that incidental PNI may serve as a marker to improve the precision in the prognostic assessment of patients with CSCC.
Authors: Flora Yan; Brittny N Tillman; Rajiv I Nijhawan; Divya Srivastava; David J Sher; Vladimir Avkshtol; Jade Homsi; Justin A Bishop; Erin M Wynings; Rebecca Lee; Larry L Myers; Andrew T Day Journal: Ann Surg Oncol Date: 2021-06-30 Impact factor: 5.344
Authors: Axel Sahovaler; Rohin J Krishnan; David H Yeh; Qi Zhou; David Palma; Kevin Fung; John Yoo; Anthony Nichols; S Danielle MacNeil Journal: JAMA Otolaryngol Head Neck Surg Date: 2019-04-01 Impact factor: 6.223