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The role of perineural invasion on head and neck adenoid cystic carcinoma prognosis: a systematic review and meta-analysis

  • Author Footnotes
    ∗ These authors contributed equally to this paper and are considered joint first authors.
    Jun Ju
    Footnotes
    ∗ These authors contributed equally to this paper and are considered joint first authors.
    Affiliations
    State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China

    Navy General Hospital of Chinese PLA, Beijing, China
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  • Author Footnotes
    ∗ These authors contributed equally to this paper and are considered joint first authors.
    Yun Li
    Footnotes
    ∗ These authors contributed equally to this paper and are considered joint first authors.
    Affiliations
    State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
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  • Juan Chai
    Affiliations
    Department of Oral and Maxillofacial Surgery, Department of Stomatology, Xi'an Medical University, Xi'an, China
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  • Chao Ma
    Affiliations
    State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
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  • Qianwei Ni
    Affiliations
    State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
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  • Zhiyuan Shen
    Affiliations
    State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
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  • Jianhua Wei
    Affiliations
    State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
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  • Moyi Sun
    Correspondence
    Reprint requests: Moyi Sun, MD, PhD, State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, No.145 West Changle Road, Xi'an 710032, China
    Affiliations
    State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
    Search for articles by this author
  • Author Footnotes
    ∗ These authors contributed equally to this paper and are considered joint first authors.
Published:August 18, 2016DOI:https://doi.org/10.1016/j.oooo.2016.08.008

      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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