Squamous cell carcinoma of skin with perineural invasion

Background: Perineural invasion of squamous cell carcinoma of the skin causes increased mortality. Objective: We compared survival rates for treatment with Mohs surgery with previous studies of conventional surgery and postoperative radiotherapy. Methods: With a computerized tumor registry we identified 44 cases of squamous cell carcinoma with perineural invasion recurrence, and hazard rates were calculated. Results: 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. Conclusion: 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.