title: Perineural invasion of the major and minor nerves in laryngeal and hypopharyngeal cancer.
abstract: OBJECTIVE
  To investigate the perineural invasion in patients with squamous cell carcinoma of the larynx and hypopharynx.
  
  
  METHODS
  A prospective study of patients with laryngeal and hypopharyngeal squamous cell carcinoma who underwent total or partial laryngectomy.
  
  
  METHODS
  Patients with squamous cell carcinoma of the larynx and pyriform sinus who underwent laryngectomy between 2002 and 2006 in the ENT Clinic of Cluj-Napoca were investigated for histopathological identification of perineural invasion.
  
  
  RESULTS
  The present study included 256 patients. Perineural invasion was present in 86 cases out of the 256. Perineural invasion was detected in the major nerves of only one case out of 219 patients who had undergone total laryngectomy. The difference between the mean disease-free survival of patients with or without perineural invasion of the minor nerves was statistically significant (Mann-Whitney U test, P = 0.000102). The local recurrence rates in the cases with or without perineural invasion were significantly different (log-rank test, P = 0.00001).
  
  
  CONCLUSIONS
  Major nerves do not constitute a way of spreading in the squamous cell carcinoma of the larynx and hypopharynx, whereas minor nerves remain a potential one.
authors.affiliation: ENT Department, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania. chirila_magda@yahoo.com
authors.forename: Magdalena
authors.initials: M
authors.lastname: Chirilă
authors.forename: Sorana D
authors.initials: SD
authors.lastname: Bolboacă
authors.forename: Marcel
authors.initials: M
authors.lastname: Cosgarea
authors.forename: Ermil
authors.initials: E
authors.lastname: Tomescu
authors.forename: Mihaela
authors.initials: M
authors.lastname: Mureşan
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology*; D007013:Hypopharynx / Q000294:innervation*; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology*; D007823:Laryngeal Nerves / Q000473:pathology*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D010525:Peripheral Nerves / Q000473:pathology*; D011446:Prospective Studies