Squamous cell carcinoma of skin with perineural invasion.

Abstract

Perineural invasion of squamous cell carcinoma of the skin causes increased mortality. We compared survival rates for treatment with Mohs surgery with previous studies of conventional surgery and postoperative radiotherapy. With a computerized tumor registry we identified 44 cases of squamous cell carcinoma with perineural invasion recurrence, and hazard rates were calculated. Of 44 patients treated with Mohs surgery, three had recurrences. On this basis a survival probability of 88.7% was calculated. Calculation of hazard rate showed highest probability of recurrence 3 to 6 years after Mohs surgery. The clinical characteristics associated with perineural tumor invasion were male sex, size of tumor (> 2 cm), forehead location, and previous therapy. When compared with conventional surgical excision and postoperative radiotherapy, early detection and treatment by Mohs surgery of squamous cell carcinoma with perineural invasion result in a much improved survival probability.