Pretreatment pain predicts perineural invasion in oral squamous cell carcinoma: A prospective study

Objectives Perineural invasion (PNI) is an established poor prognostic pathological feature for oral squamous cell carcinoma (OSCC). The purpose of this study was to analyze the role of pretreatment parameters in predicting PNI for OSCC. Materials and methods We prospectively enrolled into our study 102 newly diagnosed OSCC patients, who were surgically treated from 2011 to 2012. Before treatment, patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire H&N35 and the visual analogue scale (VAS) for cancer pain. Pathological examination was performed to ascertain PNI status in all patients. Patients were divided into two groups, those with PNI and without PNI. Pretreatment parameters were compared between the two groups. Results In univariate analysis, clinical T classification (P < 0.001), painkiller use (P = 0.001), problem with social eating (P < 0.001) and social contact (P = 0.002), VAS scores of primary pain (P < 0.001) and referred pain (P = 0.004) were found to be associated with PNI. Multivariate logistic regression analysis further revealed VAS score of primary pain (P = 0.001, OR 2.014) and T3-4 classification (P = 0.014, OR 6.422) were independent predictors of PNI. A regression equation incorporating pretreatment pain was developed to predict the probability of having PNI. Conclusion PNI can be predicted by higher pretreatment VAS score of primary pain, as well as more advanced clinical T classification. Careful evaluation of pretreatment pain of primary tumor can thus be helpful in improving treatment decision making for OSCC.