This study evaluated the role of adjuvant radiation therapy for basal cell carcinoma with perineural invasion (PNI). Findings suggested that radiation may improve local control in BCC with PNI, particularly for large-caliber nerve involvement, though patient selection remains important.

Adjuvant radiation should be considered for BCC with large-caliber perineural invasion to reduce local recurrence risk.

Small-caliber, incidental PNI in BCC may not require adjuvant radiation, and clinical judgment should guide treatment decisions.