Perineural invasion/lymphovascular invasion double positive predicts distant metastasis and poor survival in T3–4 oral squamous cell carcinoma

• Published in: Scientific reports Vol. 11; no. 1; pp. 19770 - 9
• Main Authors: Ting, Kuan-Chung, Lee, Tsung-Lun, Li, Wing-Yin, Chang, Chia-Fan, Chu, Pen-Yuan, Wang, Yi-Fen, Tai, Shyh-Kuan
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 05.10.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4028; 692/699; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Clinical trials; Female; Humanities and Social Sciences; Humans; Kaplan-Meier Estimate; Lymphatic Metastasis; Male; Metastases; Metastasis; Middle Aged; Mouth Neoplasms - mortality; Mouth Neoplasms - pathology; Mouth Neoplasms - therapy; multidisciplinary; Multivariate Analysis; Neoplasm Invasiveness; Neoplasm Staging; Oral cancer; Oral carcinoma; Oral squamous cell carcinoma; Patients; Prognosis; Public Health Surveillance; Risk groups; Science; Science (multidisciplinary); Squamous cell carcinoma; Survival Analysis; Tumors
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-99280-2

Postoperative adjuvant therapy has been indicated by advanced T classification for T3–4 oral squamous cell carcinoma (OSCC) and the significance of perineural invasion (PNI) and lymphovascular invasion (LVI) in treatment for T3–4 OSCC remains unclear. Ninety-eight cumulative patients with T3–4 OSCC who underwent curative surgery between Jan 2002 and Dec 2010 were recruited and analyzed. Twenty-seven (27.6%) patients were PNI/LVI double positive. PNI/LVI double positive demonstrated independent predictive values for higher neck metastasis (LN+), higher distant metastasis (DM) and low 5-year disease-specific survival (DSS) rates ( p  < 0.001, p  = 0.017, and p  < 0.001, respectively) after controlling for other pathologic features of the primary tumors. A high DM rate of 33.3% was noted in PNI/LVI double-positive patients. Among the PNI/LVI double negative, single positive to double positive subgroups, increasing LN+, DM rates and decreasing DSS rate were observed. Among the 44 LN+ patients, PNI/LVI double positive remained associated with a markedly high DM rate of 42.9% and a poor 5-year DSS of 27.7%. PNI/LVI double positive plays important roles in prognostication and potential clinical application for T3–4 OSCC by independently predicting LN+, DM, and poor DSS, and can be used as a good marker to select DM high-risk patients for novel adjuvant therapy trials.