title: Role of perineural invasion as a prognostic factor in laryngeal cancer.
abstract: The diffusion of laryngeal cancer cells in the perineural space is a parameter associated with a negative prognosis, high loco-regional recurrence and low disease-free survival rates. The spread of tumor cells on the perineural sheath highlights the histopathological and clinically aggressive behavior of this type of tumor, which may extend proximally or distally in the nerve for >10 cm. Therefore, the surgical resection margin is generally insufficient to treat patients with laryngeal cancer presenting with perineural invasion (PNI) with surgery alone. In PNI, the minor laryngeal nerves are frequently involved, rather than the superior and inferior laryngeal nerves. The aim of the present study was: i) To evaluate the prognostic importance of PNI; ii) to correlate the rate of infiltration with factors associated with the tumor, including histotype, site and tumor-node-metastasis stage, and with the type of surgery (total or partial laryngectomy); and iii) to evaluate the rate of disease-free survival according to the outcome of combined surgery and radiotherapy (RT) treatment, by means of retrospective analysis. The results of the present study highlighted the importance of performing a closer clinical and instrumental follow-up in patients with laryngeal cancer whose histopathological examination is positive for PNI. In such cases, it is important to complement the surgical therapeutic treatment with adjuvant RT.
authors.affiliation: Department of Neurosciences, Ear, Nose and Throat Section, University of Naples 'Federico II', Naples I-80138, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Mesolella
authors.affiliation: Department of Neurosciences, Ear, Nose and Throat Section, University of Naples 'Federico II', Naples I-80138, Italy.
authors.forename: Brigida
authors.initials: B
authors.lastname: Iorio
authors.affiliation: Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples I-80138, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Misso
authors.affiliation: Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples I-80138, Italy.
authors.forename: Amalia
authors.initials: A
authors.lastname: Luce
authors.affiliation: Department of Neurosciences, Ear, Nose and Throat Section, University of Naples 'Federico II', Naples I-80138, Italy.
authors.forename: Mariano
authors.initials: M
authors.lastname: Cimmino
authors.affiliation: Department of Neurosciences, Ear, Nose and Throat Section, University of Naples 'Federico II', Naples I-80138, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Iengo
authors.affiliation: Department of Neurosciences, Ear, Nose and Throat Section, University of Naples 'Federico II', Naples I-80138, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Landi
authors.affiliation: Unit of General and Geriatric Surgery, School of Medicine, Second University of Naples, Naples I-80137, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Sperlongano
authors.affiliation: Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, Naples I-80138, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Caraglia
authors.affiliation: Department of Neurosciences, Ear, Nose and Throat Section, University of Naples 'Federico II', Naples I-80138, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Ricciardiello
keywords: laryngeal cancer; lymph node metastasis; perineural invasion; prognostic factor; radiotherapy