title: Risks and clinical implications of perineural invasion in T1-2 oral tongue squamous cell carcinoma.
abstract: BACKGROUND
  Risks of perineural invasion (PNI) in T1-2 oral tongue squamous cell carcinoma (SCC) have not been specifically elucidated.
  
  
  METHODS
  Pathological features, including PNI, were re-reviewed under regular hematoxylin-eosin staining in 190 patients with T1-2 oral tongue SCC.
  
  
  RESULTS
  Tumor thickness >5 mm, PNI(+), and lymphovascular invasion (+) independently predicted lymph node involvement. PNI(+) and neck observation also independently predicted neck recurrence, but only PNI(+) was associated with a poor disease-specific survival (DSS; p = .003). In patients who were clinically node negative (cN0), elective neck dissection contributed to a better DSS in patients with PNI(+) tumors (p = .046), but not in patients with PNI (-) tumors (p = .809). Additionally, increased tumor thickness predicted the presence of PNI.
  
  
  CONCLUSIONS
  PNI is a crucial pathological feature for T1-2 oral tongue SCC. Elective neck dissection should be performed in patients who were cN0 with PNI. Careful evaluation for PNI should be advocated in regular pathological diagnosis.
authors.affiliation: Department of Otolaryngology, National Yang-Ming University, Taipei, Taiwan. sktai@vghtpe.gov.tw
authors.forename: Shyh-Kuan
authors.initials: SK
authors.lastname: Tai
authors.forename: Wing-Yin
authors.initials: WY
authors.lastname: Li
authors.forename: Pen-Yuan
authors.initials: PY
authors.lastname: Chu
authors.forename: Shyue-Yih
authors.initials: SY
authors.lastname: Chang
authors.forename: Tung-Lung
authors.initials: TL
authors.lastname: Tsai
authors.forename: Yi-Fen
authors.initials: YF
authors.lastname: Wang
authors.forename: Jui-Lin
authors.initials: JL
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D012306:Risk; D016019:Survival Analysis; D014059:Tongue / Q000473:pathology* / Q000601:surgery; D014062:Tongue Neoplasms / Q000473:pathology* / Q000601:surgery; D055815:Young Adult