title: Skin cancer of the head and neck with clinical perineural invasion.
abstract: OBJECTIVE
  To review treatment and outcomes in 62 patients with clinical and/or gross evidence of perineural invasion from skin cancer of the head and neck.
  
  
  METHODS
  Sixty-two patients received radiotherapy at the University of Florida as part or all of their treatment between January 1965 and April 1995. All patients had clinical signs and symptoms of perineural involvement and/or documentation of tumor extending to grossly involve nerve(s). Twenty-one patients underwent therapy for previously untreated lesions, including 12 who received radiotherapy alone and nine who had surgery with postoperative radiotherapy. Forty-one patients underwent therapy for recurrent lesions, including 18 treated with radiotherapy alone and 23 who received preoperative or postoperative radiotherapy.
  
  
  RESULTS
  Factors on multivariate analysis that predicted local control included patient age, previously untreated vs. recurrent lesions, presence of clinical symptoms, and extent of radiotherapy fields. Recurrence patterns were predominantly local; 26 of 31 patients (84%) who developed local recurrence after treatment had recurrent cancer limited to the primary site.
  
  
  CONCLUSIONS
  Many patients with skin cancer and symptomatic perineural invasion have disease that is incompletely resectable. Approximately half these patients will be cured with aggressive irradiation alone or combined with surgery. Age, prior treatment, and clinical symptoms influence the likelihood of cure.
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, USA.
authors.forename: M W
authors.initials: MW
authors.lastname: McCord
authors.forename: W M
authors.initials: WM
authors.lastname: Mendenhall
authors.forename: J T
authors.initials: JT
authors.lastname: Parsons
authors.forename: R J
authors.initials: RJ
authors.lastname: Amdur
authors.forename: S P
authors.initials: SP
authors.lastname: Stringer
authors.forename: N J
authors.initials: NJ
authors.lastname: Cassisi
authors.forename: R R
authors.initials: RR
authors.lastname: Million
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D003391:Cranial Nerves / Q000473:pathology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D016896:Treatment Outcome