Published in:
01-10-2010 | Original Paper
Perineural invasion in carcinoma of the cervix uteri—prognostic impact
Published in: Journal of Cancer Research and Clinical Oncology | Issue 10/2010
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Purpose
Limited information exists about the occurrence and the impact of perineural invasion (PNI) in patients with cervical carcinoma (CX).
Methods
The original histologic slides from patients primarily treated by radical hysterectomy and systematic pelvic lymphadenectomy were re-examined regarding the occurrence of PNI. PNI was correlated to recurrence free (RFS) and overall survival (OS).
Results
35.1% of all patients (68/194) represented perineural invasion (=PNI). The 5-year-overall-survival-rate was significantly decreased in patients representing PNI, when they were compared with those without PNI (51.1% [95% CI 38.0–64.2] vs. 75.6% [95% CI 67.8–83.4]; p = 0.001). In a separate analysis the prognostic impact persisted in the node negative, but disappeared in the node-positive cases. In multivariate analysis, pelvic lymph node involvement and PNI were independent prognostic factors for overall survival.
Conclusions
Perineural invasion is seen in about one-third of patients with cervical carcinoma. Patients affected by PNI represented a decreased overall survival. Further studies are required to get a deeper insight into the clinical impact and the pathogenetic mechanisms of PNI in CX.