Perineural invasion as a prognostic factor in head and neck squamous cell carcinoma: a systematic review and meta-analysis

Abstract

Background: Squamous cell carcinoma (SCC) is the most common type of head and neck cancer, and head and neck squamous cell carcinoma (HNSCC) was proved to having a high prevalence of perineural invasion (PNI). Although some reports have revealed a relationship between PNI and the prognosis in HNSCC patients, the contribution of PNI to the prognosis remains unclear.

Objectives: This study was aimed to comprehensively and quantitatively summarize the prognostic value of PNI for the survival of patients with HNSCC.

Material and methods: We conducted PubMed and EMBASE to identify all relevant studies. A meta-analysis and subgroup analysis were performed to clarify the prognostic role of PNI.

Results: A total of 18 studies (n = 3894) were included. 989 (25.4%) of the 3894 patients exhibited positive PNI, PNI was shown to be significantly associated with overall survival (OS) [hazard ratio (HR): 2.8, 95% confidence interval (CI): 1.88–4.16], disease-free survival (DFS) (HR = 2.42, 95% CI: 1.92–3.05) and disease-specific survival (DSS) (HR = 2.60, 95% CI: 1.86–3.63).

Conclusions: The presence of PNI significantly affected OS, DFS and DSS in patients with HNSCC.

背景：鳞状细胞癌（SCC）是最常见的头颈癌类型；头颈部鳞状细胞癌（HNSCC）被证明具有高度的神经周浸润（PNI）。尽管一些报道揭示了PNI与HNSCC患者预后之间的关系, 但PNI对预后的作用仍不清楚。

目的：本研究旨在全面地、定量地总结PNI对HNSCC患者生存的预后价值。

材料和方法：我们进行了PubMed和EMBASE, 以识别所有相关研究。进行了荟萃分析和亚组分析, 以阐明PNI的预后作用。

结果：共纳入18项研究（n = 3894）。 3894名患者中有989名（25.4％）表现出阳性PNI, PNI显示与总生存率（OS）显著相关【风险比（HR）：2.8, 95％置信区间（CI）：1.88-4.16】, 疾病 - 自由存活（DFS）（HR = 2.42, 95％CI：1.92-3.05）和疾病特异性存活（DSS）（HR = 2.60, 95％CI：1.86-3.63）。

结论：PNI的存在显著影响着HNSCC患者的OS, DFS和DSS。

Keywords:

• Perineural invasion
• head and neck squamous cell carcinoma
• prognosis
• meta-analysis

Disclosure statement

The authors report no conflict of interest in this study.

Additional information

Funding

This study was supported by The National Natural Science Foundation of China [grant numbers 81803569] without any involvement in writing this manuscript.