{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:44:24Z","timestamp":1792712664911,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,1,16]],"date-time":"2018-01-16T00:00:00Z","timestamp":1516060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1\u2010TR\u2010001857"],"award-info":[{"award-number":["UL1\u2010TR\u2010001857"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the clinical predictors and survival implications of perineural invasion (PNI) in parotid gland malignancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Patients with parotid gland malignancies treated surgically from 2000 to 2015 were retrospectively identified in the Head and Neck Cancer Registry at a single institution. Data points were extracted from the medical record and original pathology reports.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 186 patients with parotid gland malignancies were identified with a mean follow\u2010up of 5.2 years. Salivary duct carcinoma (45), mucoepidermoid carcinoma (44), and acinic cell carcinoma (26) were the most common histologic types. A total of 46.2% of tumors were found to have PNI. At the time of presentation, facial nerve paresis (odds ratio [OR], 64.7; <jats:italic>P<\/jats:italic> &lt;. 001) and facial pain (OR, 3.7; <jats:italic>P<\/jats:italic> =. 002) but not facial paresthesia or anesthesia (OR, 2.8, <jats:italic>P<\/jats:italic> =. 085) were predictive of PNI. Malignancies with PNI were significantly more likely to be of advanced T and N classification, be high\u2010risk pathologic types, and have positive margins and angiolymphatic invasion. PNI positivity was associated with worse overall (hazard ratio, 2.62; <jats:italic>P<\/jats:italic> =. 001) and disease\u2010free survival (4.18; <jats:italic>P<\/jats:italic> &lt;. 001) on univariate Cox regression analysis. However, when controlling for other negative prognosticators, age, and adjuvant therapy, PNI did not have a statistically significant effect on disease\u2010free or overall survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PNI is strongly correlated with more aggressive parotid gland malignancies but is not an independent predictor of worse survival. Facial paresis and pain were predictive of PNI positivity, and facial paresis correlated with worse overall and disease\u2010free survival.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817751888","type":"journal-article","created":{"date-parts":[[2018,1,16]],"date-time":"2018-01-16T14:43:41Z","timestamp":1516113821000},"page":"1035-1041","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Perineural Invasion in Parotid Gland Malignancies"],"prefix":"10.1002","volume":"158","author":[{"given":"Phillip","family":"Huyett","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umamaheswar","family":"Duvvuri","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Pittsburgh Medical Center Pittsburgh Pennsylvania 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