The significance of perineural invasion as a prognostic factor in cervical cancer patients of different ethnicities

Objective: The prognostic significance of perineural invasion (PNI) in cervical cancer has been previously investigated with no consistent conclusion. This study aimed at determining the prognostic value of PNI in cervical cancer patients who underwent radical hysterectomy. Method: Clinical data of 413 patients with cervical cancer (stages IB-IIB) who underwent radical hysterectomy between 2009 and 2014 were investigated retrospectively. Results: 8.0% of all patients (33/413) represented with PNI. Large tumor size (≥ 4 cm), lymph node metastasis, parametrial invasion and lymphovascular space invasion were closely associated with the presence of PNI. The 5-year recurrence-free-survival (RFS) rate was significantly decreased in all the patients with PNI (P = 0.048) or within Uyghur ethnic group (P = 0.034). The 5-year-overall-survival-rate (OS) for PNI-positive and PNI-negative patients were 70.5% and 79.9%, respectively with no significant difference (P = 0.383). Cox multivariate analysis indicated that PNI is not an independent prognostic factor for RFS or OS. Conclusion: Patients represented with PNI exhibited significantly decreased RFS in the whole cohort of patient samples as well as within Uyghur ethnic group. PNI cannot serve as an independent prognostic factor for cervical cancer patients, but is significantly associated with prognostic factors. Therefore, PNI may be a new risk factor candidate for cervical cancer.