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Perineural invasion increased recurrence risk in cutaneous squamous cell carcinoma

Patients with perineural invasion in cutaneous squamous cell carcinoma were more likely to experience recurrence than patients without perineural invasion, according to findings from a systematic review.

Researchers searched Medline and Embase databases and identified 12 studies comprising 241 patients with clinical symptoms and/or radiologic evidence of perineural invasion and 381 patients with perineural invasion found on histologic examination. Studies conducted through Nov. 11, 2016 were included in the analysis.

Disease-related outcomes served as the primary endpoint, along with 5-year recurrence-free survival, disease-specific survival and overall survival.

Patients with clinical or radiological evidence of perineural invasion had a local recurrence rate of 37%, compared with 17% for those with histologic evidence of perineural invasion (P < .001). Similarly, patients with clinical symptoms had a disease-specific mortality rate of 27%, compared with 6% for those with histologic evidence (P < .001).

Five-year recurrence-free survival rates were 61% in the clinical symptoms group and 76% in the histologic group (P = .009). Disease-specific survival rates were 70% in the clinical group and 88% in the histologic group (P = .002).

No significant differences were reported for nodal metastasis or distant metastasis with regard to classification of perineural invasion.

“Patients with [perineural invasion] may benefit from increased long-term surveillance,” the researchers concluded. “Further studies are needed to establish standardized guidelines on follow-up and dermatologic surveillance in this high-risk patient population.” – by Rob Volansky

Disclosure: The researchers report no relevant financial disclosures.