Pretreatment pain predicts perineural invasion in oral squamous cell carcinoma: A prospective study.
Perineural invasion (PNI) is an established poor prognostic pathological feature for oral squamous cell carcinoma (OSCC). The purpose of this study was to analyze the role of pretreatment parameters in predicting PNI for OSCC.



We prospectively enrolled into our study 102 newly diagnosed OSCC patients, who were surgically treated from 2011 to 2012. Before treatment, patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire H&N35 and the visual analogue scale (VAS) for cancer pain. Pathological examination was performed to ascertain PNI status in all patients. Patients were divided into two groups, those with PNI and without PNI. Pretreatment parameters were compared between the two groups.



In univariate analysis, clinical T classification (P<0.001), painkiller use (P=0.001), problem with social eating (P<0.001) and social contact (P=0.002), VAS scores of primary pain (P<0.001) and referred pain (P=0.004) were found to be associated with PNI. Multivariate logistic regression analysis further revealed VAS score of primary pain (P=0.001, OR 2.014) and T3-4 classification (P=0.014, OR 6.422) were independent predictors of PNI. A regression equation incorporating pretreatment pain was developed to predict the probability of having PNI.



PNI can be predicted by higher pretreatment VAS score of primary pain, as well as more advanced clinical T classification. Careful evaluation of pretreatment pain of primary tumor can thus be helpful in improving treatment decision making for OSCC.
Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan; Department of Otolaryngology, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan.
Chien-Fu
CF
Yeh
Department of Pathology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan.
Wing-Yin
WY
Li
Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan; Department of Otolaryngology, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan.
Pen-Yuan
PY
Chu
Department of Dentistry, School of Dentistry, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan; Department of Stomatology, Oral and Maxillofacial Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan.
Shou-Yen
SY
Kao
Department of Dentistry, School of Dentistry, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan; Department of Stomatology, Oral and Maxillofacial Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan.
Ya-Wei
YW
Chen
Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan; Department of Otolaryngology, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan.
Tsung-Lun
TL
Lee
Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan; Department of Otolaryngology, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan.
Yen-Bin
YB
Hsu
Department of Dentistry, School of Dentistry, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan; Department of Stomatology, Oral and Maxillofacial Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan.
Cheng-Chieh
CC
Yang
Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei 11217, Taiwan; Department of Otolaryngology, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan; Infection and Immunity Research Center, National Yang-Ming University, No. 155, Sec. 2, Linong St., Taipei 11221, Taiwan. Electronic address: sktai@vghtpe.gov.tw.
Shyh-Kuan
SK
Tai
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D010146:Pain / Q000209:etiology*; D010525:Peripheral Nerves / Q000473:pathology*; D011446:Prospective Studies
Oral squamous cell carcinoma; Pain; Perineural invasion; Quality of life; Visual analogue scale