{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T07:39:47Z","timestamp":1769153987455,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To present an institution's experience and survival outcomes for patients with head and neck cutaneous squamous cell carcinoma (HNcSCC) and perineural spread (PNS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Retrospective study of patients with HNcSCC and PNS treated between January 2010 and August 2020 from the Sydney Head and Neck Cancer Institute database, Sydney, Australia; a high\u2010volume, tertiary, academic head and neck centre. Patient demographics, primary site, involved cranial nerves, treatment modality, loco\u2010regional failure and survival data were obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010five patients were identified, of which 32 patients were male (71%). Mean age at diagnosis was 68.7\u2009years (range 43\u201390). Median follow\u2010up was 16.1\u2009months (range 1\u2013107). The trigeminal nerve was most frequently involved (<jats:italic>n<\/jats:italic>\u00a0=\u00a030, 66.6%) followed by facial nerve (<jats:italic>n<\/jats:italic>\u00a0=\u00a013, 28.9%). Most patients underwent surgery followed by radiotherapy (<jats:italic>n<\/jats:italic>\u00a0=\u00a033, 73%) and eight received definitive radiotherapy. The median overall survival (OS) was 4.5\u2009years (95% CI 3.71\u20135.38), median disease\u2010specific survival 5.1\u2009years (95% CI 4.21\u20135.97) and median disease\u2010free survival (DFS) was 1.7\u2009years (95% CI 1.11\u20132.22). The estimated 5\u2010year OS and DFS were 45% and 25%, respectively. Patients treated with surgery and adjuvant radiotherapy with a clear proximal nerve margin had favourable DFS (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.035) and trended towards better OS (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.134) compared with patients with an involved nerve margin. Patients treated surgically with involved proximal nerve margins had similar outcomes compared with patients with treated definitive radiotherapy (HR 0.80, 95% CI 0.29\u20132.22,<jats:italic>P<\/jats:italic>\u00a0=\u00a00.664).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The likelihood of achieving a clear proximal nerve margin should be a strong consideration in the selection of appropriate patients for primary surgery<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.17908","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T08:01:21Z","timestamp":1658476881000},"page":"2299-2304","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Survival outcomes of perineural spread in head and neck cutaneous squamous cell carcinoma"],"prefix":"10.1111","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8487-9371","authenticated-orcid":false,"given":"Daniel","family":"Phung","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery Chris O'Brien Lifehouse Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4338-8741","authenticated-orcid":false,"given":"Navid","family":"Ahmadi","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Sydney Medical School, The Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruta","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Sydney Medical School, The Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"},{"name":"Department of Tissue Pathology and Diagnostic Oncology Royal Prince Alfred Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan R.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Sydney Medical School, The Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"},{"name":"The Royal Prince Alfred Institute of Academic Surgery Sydney Local Health District Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Wykes","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Department of Head and Neck Surgery Wollongong Hospital New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sydney","family":"Ch'ng","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Sydney Medical School, The Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael S.","family":"Elliott","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Sydney Medical School, The Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten E.","family":"Palme","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Chris O'Brien Lifehouse Sydney New South Wales 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