Volume 15, Number 4, December 2003

Impact of Perineural Invasion on Survival of Patients with Tongue Carcinoma

Bibi Rahima, Susumu Shingaki, Takayuki Nakazato, Chikara Saito

First Department of Oral and Maxillofacial Surgery, Niigata University, Faculty of Dentistry, Niigata, Japan

Objective: To assess the prognostic significance of perineural invasion in squamous cell carcinoma of the tongue.
Patients and Methods: A retrospective study of 68 patients with previously untreated squamous cell carcinoma of the tongue was undertaken to evaluate the prognostic significance of perineural invasion in relation to clinicopathological factors (age, sex, T-stage, tumour differentiation, lymph node metastasis, lymphatic-vascular invasion, depth of invasion, and surgical margin), recurrence, and survival.
Results: Perineural invasion was present in 17 of 68 patients (25%) and only lymph node metastasis was significantly associated with perineural invasion (p = 0.002). Fifteen patients (22%) developed recurrent disease involving the primary site in 4, neck in 9, and distant sites in 2. In the univariate analysis, perineural invasion (p = 0.001), lymph node metastasis (p = 0.004), and depth of invasion (p = 0.013) had significant impact on recurrence of disease. At multivariate analysis, however, only perineural invasion was a significant independent predictor of recurrence (p = 0.005). The 5-year overall and disease-specific survival rates for the entire series were 77% and 84%, respectively. The 5-year disease-specific survival rates for patients with and without perineural invasion were 59% and 92%, respectively, (p = 0.001).
Conclusion: Perineural invasion is a significant factor that determines the prognosis of patients with tongue carcinoma.

Key words:
Lymph node metastasis, Recurrence, Survival, Tongue cancers

Asian J Oral Maxillofac Surg. 2003;15:243-249.
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