Prognostic Significane Of Perineural Invasion In Early-Stage Cervical Cancer

Objective:To explore incidence and clinically prognostic significance of perineural invasion in early-stage cervical cancer.Methods:Clinical data of 183 patients with cervical cancer stages Ia2-IIb (155 stages Ia2-IIa2 and 28 stages â…¡b) who underwentradical hysterectomyan pelvic lymphadenectomy between January 2007 and April 2012 in sichuan cancer hospital were analyzed retrospectively.It was to explore the incidence and the clinically prognostic influence of perineural invasion in early-stage cervical cancer. Survival curves were estimated by the Kaplan-Meier method and statistical significance was determined by a log-rank test. Cox proportionalhazard regression analysis was carried out todetermine clinicopathologic variables as prognostic factors. Results: Perineural invasion was detected in 7.74%(12 of 155 cases) of early-stage patients. Perineural invasion was associated with cervical cancer FIGO clinical stage (P= 0.048).Perineural invasion was significantly associated with cervical stroma infiltration depth,parametrial invasion,lymphovascular invasion and recurrence(P<0.001).The deep cervical stroma infiltration was positive factor to the occurrence of perineural invasion. Patients with perineural invasion represented significantly reduced 5-year-disease-free-survival (64.29% vs 87.8%, P=0.021) and 5-year-overall-survival-rate (65.63% vs 91.91%, P=0.039) when they were compared with patients without perineural invasion.Without the preoperative neoadjuvant chemotherapy patients 5-year-overall-survival-rate (P=0.035) statistically significantly decreased in patients representing perineural invasion,when they were compared with those without perineural invasion.On DFS univariate analysis,perineural invasion was an independent prognostic factor,but in a multivariate, DFSCox-regression analysis:pelviclymph node involvement and cervical stroma infiltration depth represented as independent prognostic factor for Disease-free-survival in early cervical cancer.Perineural invasion was associated with poor tumor differentiation and parametrial invasion. Conclusions:Perineural invasion was found to be associated with multiple high-risk factors and recurrence in early-stage cervical cancer,leading a decreased overall survival and disease-free survival.Perineural invasion was a importantly poor prognostic factor for in early-stage cervical cancer.