title: [Evidence of perineural invasion on early-stage cervical cancer and prognostic significance].
abstract: OBJECTIVE
  To evaluate the incidence and significance of perineural invasion (PNI) in cervical cancer.
  
  
  METHODS
  Retrospective chart review of patients with cervical cancer (stages Ia2-IIb) who underwent radical hysterectomy and pelvic lymphadenectomy from 2007 to 2012. To evaluate the incidence and significance of PNI in cervical and uterine tissues by microscopic examination.
  
  
  RESULTS
  A total of 238 patients were included, 9.2% (22/238) patients with PNI in the cervical stroma. Patients with PNI were more likely to have adverse histopathologic features, including lymphoma vascular space invasion, parametrical invasion, depth of invasion, tomor size and lymph nodes metastases (all P < 0.05). PNI were independent of age, international federation of gynecology and obstetrics (FIGO) stage, histopathology type and grade, and positive vaginal margin (all P > 0.05). Patients with PNI had shorter disease-free and overall survival (P = 0.002 and P = 0.008, respectively). On multivariate analysis, risk factors for recurrence and death included parametrical invasion and depth of invasion (P < 0.05). Similarly, risk factors for recurrence included lymph nodes metastases (P = 0.024). However, PNI was not identified as an independent risk factor for either recurrence or death (P > 0.05).
  
  
  CONCLUSIONS
  PNI exists in early cervical cancer. PNI is associated with tumor size, depth of invasion, parametrical invasion, lymphoma vascular space invasion and lymph nodes metastases. PNI represente a decreasing disease-free and overall survival in patients with early-stage cervical cancer, and is independently associated with multiple high-risk factors, which be informed management decisions regarding adjuvant therapy.
authors.affiliation: Department of Gynecological Oncology, Sichuan Cancer Hospital, Chengdu 610041, China; Email: zhanggn@hotmail.com.
authors.forename: Guonan
authors.initials: G
authors.lastname: Zhang
authors.forename: Yan
authors.initials: Y
authors.lastname: Yang
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhu
authors.forename: Ling
authors.initials: L
authors.lastname: Cui
authors.forename: Shijun
authors.initials: S
authors.lastname: Jia
authors.forename: Yu
authors.initials: Y
authors.lastname: Shi
authors.forename: Shuiqin
authors.initials: S
authors.lastname: Song
authors.forename: Shiqiang
authors.initials: S
authors.lastname: Xu
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D015994:Incidence; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D010525:Peripheral Nerves / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery