Prognostic significance of perineural invasion in cervical cancer

Int J Gynecol Pathol. 2013 Mar;32(2):228-33. doi: 10.1097/PGP.0b013e318257df5f.

Abstract

Perineural invasion (PNI) has attracted attention as a new prognostic factor for cancer. We aimed to investigate the prognostic value of PNI in patients with cervical cancer. Clinical data of 185 patients with early-stage cervical cancer (stages IA2-IIA2) who underwent radical hysterectomy and pelvic lymphadenectomy between 2003 and 2011 were investigated. PNI was detected in 7% (13 of 18 cases) of patients. Moreover, 92% (12 of 13 cases) of patients with PNI received radiation therapy or concurrent chemoradiation therapy after surgery. We investigated whether PNI can be a new indication for adjuvant therapy for cervical cancer. In our study, PNI had a significant association with well-known indications for adjuvant therapy (92.3% sensitivity, 50% specificity, odds ratio 12.0, P = 0.003). Multivariate analysis showed that parametrial invasion and lymphovascular invasion were independently associated with PNI (P < 0.05). However, statistical analysis did not show differences in disease-free survival (P = 0.292) or overall survival (P = 0.346) according to the presence of PNI. In conclusion, PNI as an independent predictor for prognosis was limited, but PNI had a significant association with prognostic factors. PNI may be a new risk factor candidate for cervical cancer. PNI is expected to help in decision making for the need for adjuvant therapy.

MeSH terms

  • Cervix Uteri / innervation
  • Chemoradiotherapy, Adjuvant
  • Female
  • Humans
  • Hysterectomy
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Invasiveness / pathology*
  • Peripheral Nerves / pathology*
  • Prognosis
  • Radiotherapy, Adjuvant
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / surgery