Association of Cervical Lymph Node Metastasis and Perineural Invasion in Patients with Oral Cavity Squamous Cell Carcinoma

Abstract

Background: Cervical lymph node metastasis (CLNM) is one of the key prognostic factors in oral squamous cell carcinoma and positive perineural invasion (PNI) is a predictor of cervical lymph node metastasis, recurrence, and decline-free survival. This study determines perineural invasion association with cervical lymph node metastasis in oral cavity squamous cell carcinoma (OCSCC).

Method: We analyzed the laboratory data collected from the surgical pathology files of a tertiary care hospital in Karachi. This retrospective study included all diagnosed cases of OCSCC that underwent cervical lymph node dissection during the 10-year period from June 2008 to March 2019. The cases were characterized according to age, gender, perineural invasion, and lymph node metastasis. The data was analyzed using SPSS and Chi-Square test was used to find the association between the cervical lymph node metastatic and PNI status.

Results: A total of 527 diagnosed cases of OCSCC with cervical neck dissection were found. It is evident from our study that OCSCC with neck dissection specimens is frequently seen in males, mostly belonging to the middle adult age group followed by young adults. Of the 527 cases, 165 showed PNI (31.3%), and 20% of the PNI cases were positive for cervical lymph node metastasis, while 40% showed benign cervical lymph nodes with negative PNI.

 Conclusion: This study highlights the single parameter of PNI and its association with cervical lymph node metastasis and showed a significant relationship between perineural invasion and cervical lymph node metastatic status (p < .001).