Objective
We performed a systematic review to assess the prognostic value of perineural invasion
(PNI) for patients with head and neck adenoid cystic carcinoma.
Study Design
A literature search of MEDLINE and EMBASE was used to identify relevant literature
up to December 2015. The primary outcomes of interest were overall survival, disease-free
survival, and locoregional control. Study information and hazard ratios (HRs) were
extracted, and HRs were pooled using the Mantel-Haenszel fixed-effects model and the
DerSimonian and Laird random-effects model according to heterogeneity.
Results
Twenty-two studies and 1332 patients were included in this study. The PNI ratio was
43.2%. PNI was at increasing risk for overall survival (HR = 2.98; 95% confidence
interval [CI] 2.00-4.46), disease-free survival (HR = 1.88; 95% CI, 1.42-2.49), and
locoregional control (HR = 2.15; 95% CI, 1.48-3.13) with statistical significance.
Conclusions
PNI is an independent factor for poor prognosis in patients with head and neck adenoid
cystic carcinoma. Moreover, PNI poses a significantly higher threat to male patients
and younger patients.
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Article info
Publication history
Published online: August 18, 2016
Accepted:
August 8,
2016
Received in revised form:
July 16,
2016
Received:
March 15,
2016
Footnotes
Prof. Sun is supported by the National Natural Science Foundation of China (Grant No.H1625).
Identification
Copyright
© 2016 Published by Elsevier Inc.
