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Updated: May 22, 2025

A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma

A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma

Published on: January 5, 2017

Impact of WPOI-5 on Risk of Regional Recurrence in Early Oral Cancer With pN0 Neck.

Justin Hintze¹, Nadia van den Berg¹, Deirdre Callanan¹

¹Department of Otolaryngology, South Infirmary Victoria University Hospital, Cork, Ireland.

The Laryngoscope

|May 21, 2025

Summary

Worst pattern of invasion category 5 (WPOI-5) is a key risk factor for isolated regional recurrence in early oral squamous cell carcinoma (OSCC) patients with negative neck dissections. Further research is needed on postoperative radiotherapy for these cases.

Keywords:

WPOI‐5 elective neck dissection head and neck neck neck dissection oral cavity pN0 squamous cell carcinoma

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Area of Science:

Oncology
Head and Neck Surgery
Cancer Recurrence

Background:

Regional recurrence (RR) affects 7%-17% of oral squamous cell carcinoma (OSCC) patients with pathologically negative (pN0) necks.
Risk factors for isolated RR in early OSCC are not well-defined.

Purpose of the Study:

To identify risk factors for isolated regional recurrence in early OSCC patients with clinically and pathologically negative necks.

Main Methods:

Retrospective cohort study involving 202 patients with clinically staged T1/2N0 OSCC.
Analysis of elective neck dissection (ND) outcomes in 130 patients, with 98 classified as pN0.

Main Results:

Isolated RR occurred in 5.1% of pN0 patients post-elective ND.
Worst pattern of invasion category 5 (WPOI-5) and absence of postoperative radiotherapy (PORT) were linked to isolated RR.
WPOI-5 was the sole significant independent risk factor on multivariate analysis.

Conclusions:

Isolated RR is a risk in over 5% of early OSCC patients with pN0 necks after ND.
WPOI-5 is a critical predictor of isolated RR in pN0 cases.
The role of PORT in WPOI-5 positive patients requires further investigation.