Perineural Invasion in Cervical Cancer: Clinical Correlates and Prognostic Implications from a Retrospective Cohort Study
| Author | Maryam Vajihinejad | en |
| Author | Mojgan Hajisafari-Tafti | en |
| Author | Fatemeh Shojaee | en |
| Orcid | Mojgan Hajisafari-Tafti [0000-0001-7352-9341] | en |
| Issued Date | 2026-12-31 | en |
| Abstract | Background: Cervical cancer remains a major global health concern, particularly in developing countries. Perineural invasion (PNI) is a well-established adverse prognostic indicator in several cancers; however, its prognostic significance in cervical cancer has been reported inconsistently. Objectives: This study aimed to determine the prevalence of PNI in cervical cancer, investigate its associations with clinicopathological characteristics, and evaluate its impact on patient survival. We hypothesized that PNI is associated with more aggressive tumor characteristics and poorer survival outcomes. Methods: This retrospective cohort study included a consecutive series of 33 patients with cervical cancer who underwent abdominal radical hysterectomy at Shahid Sadoughi Hospital, Yazd, between 2012 and 2023. Patients were included if they underwent primary surgical treatment and had complete medical records. Adjuvant chemotherapy was administered postoperatively in selected cases according to clinical indications. Patients who had received neoadjuvant therapy or had incomplete data were excluded. When pathology slides or paraffin blocks were unavailable, PNI status could not be evaluated; however, the remaining variables were analyzed in these cases. Clinical and pathological data, including age, tumor stage and size, depth of stromal invasion, lymph node involvement, lymphovascular space invasion (LVSI), parametrial involvement, margin status, tumor histological type, treatment method, and PNI status, were reviewed. Survival data were obtained through follow-up. Statistical analyses included descriptive statistics, chi-square tests, t tests, and Kaplan-Meier survival curves. Results: Perineural invasion was detected in 32% of evaluable cases (8/25) and was significantly associated with deep stromal invasion (P = 0.04) and positive surgical margins (P = 0.03). No significant correlations were observed with tumor size, lymph node status, LVSI, parametrial involvement, treatment type, or other clinicopathologic variables. Most patients presented with early-stage disease (66.7% stage IB1), and nonkeratinized squamous cell carcinoma (SCC) was the predominant subtype (48.5%). Survival analysis was limited by low mortality (2 deaths) and showed no significant difference by PNI status (P = 0.51). Conclusions: Perineural invasion is present in a substantial proportion of cervical cancer cases and is associated with aggressive tumor characteristics. Although survival data are limited, PNI is indicative of a poorer prognosis. Routine assessment of PNI is recommended to improve risk stratification and guide therapy. Larger studies are needed to clarify its prognostic and therapeutic significance. | en |
| DOI | https://doi.org/10.5812/ijcm-165929 | en |
| URI | https://brieflands.com/journals/ijcm/articles/165929 | en |
| Keyword | Perineural Invasion | en |
| Keyword | Cervical Cancer | en |
| Keyword | Prognostic Factor | en |
| Publisher | Brieflands | en |
| Title | Perineural Invasion in Cervical Cancer: Clinical Correlates and Prognostic Implications from a Retrospective Cohort Study | en |
| Type | Research Article | en |
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