Perineural invasion is a significant prognostic factor in oral squamous cell carcinoma: a systematic review and meta-analysis

Binmadi, N. ORCID: https://orcid.org/0000-0002-2200-6206, Alsharif, M. ORCID: https://orcid.org/0000-0002-0997-7171, Almazrooa, S. ORCID: https://orcid.org/0000-0001-6350-3578, Aljohani, S. ORCID: https://orcid.org/0000-0002-4169-6046, Akeel, S. ORCID: https://orcid.org/0000-0001-8006-1185, Osailan, S., Shahzad, M., Elias, W. and Mair, Y. (2023) Perineural invasion is a significant prognostic factor in oral squamous cell carcinoma: a systematic review and meta-analysis. Diagnostics, 13 (21). 3339. ISSN 2075-4418 doi: 10.3390/diagnostics13213339

Abstract/Summary

(1) Objectives: This systematic review and meta-analysis aimed to summarize current evidence regarding the prognostic role of perineural invasion (PNI) in patients with oral squamous cell carcinoma (OSCC). (2) Methods: We searched Cochrane Central, ProQuest, PubMed, Scopus, Science Direct, and Web of Science, using relevant keywords to identify eligible articles. Two independent reviewers conducted two-stage screening, data extraction, and quality assessment. The risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) criteria. All analyses were performed using comprehensive meta-analysis (CMA; version 3.3.070) software. (3) Results: The study included 101 published articles encompassing 26,062 patients. The pooled analyses showed that PNI was associated with significantly worse overall survival (OS; HR = 1.45, 95% CI: 1.32–1.58; p < 0.001), worse disease-specific survival (DSS; HR = 1.87, 95% CI: 1.65–2.12; p < 0.001), and worse disease-free survival (DFS; HR = 1.87, 95% CI: 1.65–2.12; p < 0.001). Similarly, both local recurrence-free survival (LRFS) and regional recurrence-free survival (RRFS) were worse in patients with PNI (HR = 2.31, 95% CI: 1.72–3.10, p < 0.001; and HR = 2.04, 95% CI: 1.51–2.74, p < 0.001), respectively. The random-effect estimate of three studies demonstrated that the presence of PNI was associated with worse failure-free survival (FFS; HR = 2.59, 95% CI: 1.12–5.98, p < 0.001). (4) Conclusions: The current evidence suggests that PNI can be used as an independent predictor of the prognosis for patients with OSCC. The presence of PNI was associated with worse OS, DFS, DSS, FFS, and with recurrence. Asian patients and patients with extra-tumoral or peripheral PNI invasion were associated with worse prognosis.

Item Type	Article
URI	https://reading-clone.eprints-hosting.org/id/eprint/113919
Identification Number/DOI	10.3390/diagnostics13213339
Refereed	Yes
Divisions	Life Sciences > School of Biological Sciences > Biomedical Sciences
Uncontrolled Keywords	Clinical Biochemistry
Publisher	MDPI AG
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