The following is a summary of “Basal Cell Carcinoma With Perineural Invasion: A Systematic Review and Pooled Survival Analysis” published in the November 2022 issue of Dermatologic Surgery by Abushukur, et al.

The presence of perineural invasion (PNI) is a highly concerning histopathologic hallmark of several types of skin cancer. Despite its significance in squamous cell carcinoma, the role of perineural invasion in basal cell carcinoma (BCC) is little understood. The goal of this study is to examine the relationship between demographic, clinical, and therapeutic data for BCC with PNI and the occurrence of recurrence, progression of illness, and cancer-specific mortality (CSM). Case reports and series of patients with perineural BCC were used to conduct a systematic review and pooled survival analysis.

The Results of this analysis comprise data from 159 patients in 49 different studies. At least 1 recurrence was recorded by 57 individuals. Patients who did not have a recurrence (n=79) were followed for a median of 31 months, while those who did had a recurrence (n=32) were followed for a median of 21 months. 5 year survival was 90.9% (95% CI 0.796-0.961) and the cumulative incidence of CSM was 8.5% (95% CI 0.028-0.186).

Poor prognosis of BCC with PNI is associated with male gender, multifocal nerve involvement, presence of clinical complaints, and PNI found on imaging. Early clinical identification, prior to the start of symptomatic PNI and multifocal nerve involvement, is crucial because of the high rate of illness recurrence and inadequate cumulative incidence of CSM.