title: Perineural invasion in carcinoma of the cervix uteri--prognostic impact.
abstract: OBJECTIVE
  Limited information exists about the occurrence and the impact of perineural invasion (PNI) in patients with cervical carcinoma (CX).
  
  
  METHODS
  The original histologic slides from patients primarily treated by radical hysterectomy and systematic pelvic lymphadenectomy were re-examined regarding the occurrence of PNI. PNI was correlated to recurrence free (RFS) and overall survival (OS).
  
  
  RESULTS
  35.1% of all patients (68/194) represented perineural invasion (=PNI). The 5-year-overall-survival-rate was significantly decreased in patients representing PNI, when they were compared with those without PNI (51.1% [95% CI 38.0-64.2] vs. 75.6% [95% CI 67.8-83.4]; p = 0.001). In a separate analysis the prognostic impact persisted in the node negative, but disappeared in the node-positive cases. In multivariate analysis, pelvic lymph node involvement and PNI were independent prognostic factors for overall survival.
  
  
  CONCLUSIONS
  Perineural invasion is seen in about one-third of patients with cervical carcinoma. Patients affected by PNI represented a decreased overall survival. Further studies are required to get a deeper insight into the clinical impact and the pathogenetic mechanisms of PNI in CX.
authors.affiliation: Division of Breast Gynecologic and Perinatal Pathology, Institute of Pathology, University of Leipzig, Liebigstrasse 26, 04103 Leipzig, Germany. hornl@medizin.uni-leipzig.de
authors.forename: Lars-Christian
authors.initials: LC
authors.lastname: Horn
authors.forename: Alexandra
authors.initials: A
authors.lastname: Meinel
authors.forename: Uta
authors.initials: U
authors.lastname: Fischer
authors.forename: Karl
authors.initials: K
authors.lastname: Bilek
authors.forename: Bettina
authors.initials: B
authors.lastname: Hentschel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010525:Peripheral Nerves / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery