Perineural Invasion Is Not an Independent Risk Factor for Recurrence and Lateral Neck Metastasis in Thyroid Cancer: A Propensity Score Matching Analysis
Authors' conclusion
The PNI in thyroid cancer was associated with higher recurrence rates and increased N1b. However, it was not considered a significant independent risk factor for recurrence or N1b. Further research is needed to refine the management strategies for patients with PNI to improve prognosis.
Study context
- Population
- Patients with thyroid cancer who underwent surgery, January 2000 to December 2020, Seoul St. Mary's Hospital
- Participants
- 8,572 patients
- Exposure
- Perineural invasion (PNI) vs no PNI
- PNIn = 144
- Outcome
- Recurrence and lateral neck lymph node metastasis (N1b)
Methodological detailspropensity score matching, single-centre
- Propensity score matching
- Single-centre
Main finding
As reported in the abstract
Recurrence rate
- Recurrence rates higher with PNI before (11.1% vs 5.6%) and after propensity score matching (PSM) (11.3% vs 5.6%)
- PNI a significant risk factor for recurrence in Cox regression before PSM but not after PSM
- PNI a significant risk factor for N1b in univariate logistic regression but not in multivariate analysis, before and after PSM
- PNI vs No PNI: before PSM: 11.1% vs 5.6%; after PSM: 11.3% vs 5.6%
Observational data: associations, not effects.
Further findings
Prevalence of PNI
- Patients with PNI
- 144 (1.7%)
Clinicopathologic characteristics
- PNI had higher rates of gross extrathyroidal extension, vascular and lymphatic invasion, and advanced TNM stage
Original publication
Perineural Invasion Is Not an Independent Risk Factor for Recurrence and Lateral Neck Metastasis in Thyroid Cancer: A Propensity Score Matching Analysis. Endocr Pract. Published 3 June 2025. doi:10.
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