{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:01:47Z","timestamp":1791820907593,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T00:00:00Z","timestamp":1567641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Prognostic significance of perineural invasion (PNI) in oral squamous cell carcinoma (OSCC) characterized as unifocal and multifocal was compared to depth of invasion (DOI) and extranodal extension (ENE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Univariable and multivariable analyses of 861 consecutive patients with OSCC undergoing treatment between 1995 and 2018 were performed, with local failure (LF) and disease\u2010specific mortality (DSS) as the primary endpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After adjusting for other adverse histopathological factors and adjuvant therapy, multifocal PNI was associated with a greater risk of LF (\n                      <jats:italic>P<\/jats:italic>\n                      =\u2009.01) and DSS (\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.02) compared to DOI. The effect of multifocal PNI was comparable to the effect of nodal metastases without ENE (\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.02). LF and DSS were not improved by the administration of adjuvant radiotherapy within unifocal or multifocal PNI groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multifocal PNI is associated with a greater risk of death in OSCC than DOI. Its effect is comparable to that of nodal metastases (without ENE).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.25940","type":"journal-article","created":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T09:22:10Z","timestamp":1567675330000},"page":"3992-3999","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Multifocal perineural invasion is a better prognosticator than depth of invasion in oral squamous cell carcinoma"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5170-787X","authenticated-orcid":false,"given":"Shaheen","family":"Hasmat","sequence":"first","affiliation":[{"name":"Sydney Head and Neck Cancer Institute Chris O'Brien Lifehouse  Sydney New South Wales Australia"},{"name":"Central Clinical School University of Sydney  Sydney New South Wales 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