Perineural invasion in incisional biopsy is an indication for en block resection in oral squamous cell carcinoma of the tongue and floor of the mouth

Abstract

Abstract Purpose; Oral squamous cell carcinoma is a worldwide disease associated with severe morbidity, recurrence and limited survival rates. The histologic finding of perineural invasion is a poor prognostic factor with an incidence of up to 40% in primary and recurrent cases. The aim of this study is to detect factors that influence prognosis in patients operated for oral cancer with perineural invasion in their histopathology report and to propose safer options of treatment with respect to recurrence and survival rates. Patients and methods; Overall, 75 cases of patients operated for oral squamous cell carcinoma were included in the study. Of these cases, 14 with perineural invasion were found. We created two groups: one group of patients treated with en-block resection and a second group of patients treated with a discontinuous resection between the primary site and the neck. Results; Oral cancer patients with known perineural invasion treated with en-block resection had a much better overall and disease specific survival than patients treated with a discontinuous manner (p < .001). The difference of recurrence rate between these two groups of patients was found to be very significant in our study (p < .0005) Conclusion It is therefore our suggestion that in oral squamous cell carcinoma of the tongue and floor of the mouth with perineural invasion detected in the incisional biopsy, an extended en-block resection to include the affected nerves should be performed.