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Perineural invasion in incisional biopsy is an indication for in-continuity resection in oral squamous cell carcinoma of the tongue and floor of the mouth

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Abstract

Purpose

The histologic finding of perineural invasion is a poor prognostic factor in oral squamous cell carcinoma patients. The aim of this study is to detect factors that influence prognosis in patients operated for oral cancer with perineural invasion in their histopathology report and to propose safer options of treatment with respect to recurrence and survival rates.

Patients and methods

We performed a prospective cohort study of all oral squamous cell carcinoma cases operated in our department from January 2018 to January 2022. Overall, 75 cases of patients operated for oral squamous cell carcinoma were included in the study. Of these cases, 14 with perineural invasion were found. We created two groups: one group of patients treated with in-continuity resection and a second group of patients treated with a discontinuous resection between the primary site and the neck. Type of operation was considered the predictor variable and recurrence, survival or death, the outcome variables.

Results

Oral cancer patients with known perineural invasion treated with in-continuity resection had a much better overall and disease-specific survival than patients treated with a discontinuous manner (p < .001). The difference in recurrence rate between these two groups of patients was found to be very significant in our study (p < .0005).

Conclusion

It is therefore our suggestion that in oral squamous cell carcinoma of the tongue and floor of the mouth with perineural invasion detected in the incisional biopsy, an extended in-continuity resection to include the affected nerves should be performed.

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Data Availability

Charts of patients available.

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Acknowledgements

The authors of this paper wish to sincerely thank Ms. Maria Elli Doufexi Kaplani, Sociologist, who conducted the statistical analyses of this research.

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Authors and Affiliations

  1. Evgenidio Hospital, Athens, Greece

    George Kostakis & Panagiotis Papadopoulos

  2. KAT General Hospital, Athens, Greece

    Panagiotis Stathopoulos

Authors
  1. George Kostakis
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  2. Panagiotis Papadopoulos
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  3. Panagiotis Stathopoulos
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Contributions

GC, PP: conception and design of study/review/case series. PS: acquisition of data: laboratory or clinical/literature search. GC, PS: analysis and interpretation of data collected. PS: drafting of article and/or critical revision. GC, PP: final approval and guarantor of manuscript.

Corresponding author

Correspondence to Panagiotis Stathopoulos.

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The authors declare no competing interests.

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Institutional Review Board approval was received.

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The authors declare no competing interests.

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Kostakis, G., Papadopoulos, P. & Stathopoulos, P. Perineural invasion in incisional biopsy is an indication for in-continuity resection in oral squamous cell carcinoma of the tongue and floor of the mouth. Oral Maxillofac Surg 28, 779–783 (2024). https://doi.org/10.1007/s10006-023-01205-y

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  • DOI: https://doi.org/10.1007/s10006-023-01205-y

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