Prognostic significance of perineural invasion in cervical cancer.
Perineural invasion (PNI) has attracted attention as a new prognostic factor for cancer. We aimed to investigate the prognostic value of PNI in patients with cervical cancer. Clinical data of 185 patients with early-stage cervical cancer (stages IA2-IIA2) who underwent radical hysterectomy and pelvic lymphadenectomy between 2003 and 2011 were investigated. PNI was detected in 7% (13 of 18 cases) of patients. Moreover, 92% (12 of 13 cases) of patients with PNI received radiation therapy or concurrent chemoradiation therapy after surgery. We investigated whether PNI can be a new indication for adjuvant therapy for cervical cancer. In our study, PNI had a significant association with well-known indications for adjuvant therapy (92.3% sensitivity, 50% specificity, odds ratio 12.0, P = 0.003). Multivariate analysis showed that parametrial invasion and lymphovascular invasion were independently associated with PNI (P < 0.05). However, statistical analysis did not show differences in disease-free survival (P = 0.292) or overall survival (P = 0.346) according to the presence of PNI. In conclusion, PNI as an independent predictor for prognosis was limited, but PNI had a significant association with prognostic factors. PNI may be a new risk factor candidate for cervical cancer. PNI is expected to help in decision making for the need for adjuvant therapy.
Departments of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Republic of Korea.
Hyun Chul
HC
Cho
Haeryoung
H
Kim
Hye-yon
HY
Cho
Kidong
K
Kim
Jae Hong
JH
No
Yong-Beom
YB
Kim
D002584:Cervix Uteri / Q000294:innervation; D059186:Chemoradiotherapy, Adjuvant; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D010525:Peripheral Nerves / Q000473:pathology*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery