Are Throat Pain and Otalgia Predictive of Perineural Invasion in Squamous Cell Carcinoma of the Oropharynx?

Purpose: Head and neck cancer is often associated with pain and perineural invasion (PNI). The purpose of this study was to determine the association of pain complaints and the microscopic identification of PM in patients with oropharyngeal squamous cell carcinoma (OPSCC). Patients and Methods: A retrospective cohort study was performed including patients diagnosed with OPSCC from 2010 to 2019. Patients diagnosed and operated on with curative intent at 2 institutions were included. The primary predictor variable was pain (measured as no pain, ear pain, throat pain, or simultaneous pain). Other variables were patient demographics, p16 status, and TNM staging. The primary outcome variable was the histologic presence of PNI. Chi-square analysis was performed to test for any significant associations between pain, T stage, overall stage, and p16 status in relation to PNI outcome. Multivariate logistic regression analysis was used to control for cancer staging variables when testing the association between pain and PM. Results: The final sample was composed of 157 subjects of whom 126 were men. The mean age was 59.7 years. Seventy-seven (49.0%) presented with no pain, while 35 (22.3%), 39 (24.8%), and 6 (3.8%) presented with both throat/ear pain, throat pain only, and ear pain only, respectively. Patients with simultaneous pain had 3.41 times higher odds of PNI compared to the no pain group (P = .02), although only pathologic T stage 4 and a diagnosis on the base of the tongue were independent postoperative predictors of PNI (P < .05). Conclusions: Our study demonstrates that otalgia is a preoperative predictor of PM in OPSCC and also demonstrates a trend of increasing pain complaints with PM. (C) 2021 The American Association of Oral and Maxillofacial Surgeons.

Automated summary

This study aimed to determine the association between pain complaints and perineural invasion in patients with oropharyngeal squamous cell carcinoma. The results showed that otalgia is a preoperative predictor of perineural invasion and there is an increased occurrence of perineural invasion in patients with pain symptoms.