Extranodal extension in oral squamous cell carcinoma: clinical and histopathological analysis

Area of Science:

• Oncology
• Head and Neck Surgery
• Pathology

Background:

• Extranodal extension (ENE) is a critical prognostic indicator in oral squamous cell carcinoma (OSCC).
• Accurate stratification of ENE is essential for predicting patient outcomes.

Purpose of the Study:

• To evaluate the clinical significance of differentiating between minor (ENEmi) and major (ENEma) extranodal extension in OSCC.
• To assess the impact of ENE stratification on survival and metastasis in OSCC patients.

Main Methods:

• Retrospective cohort study of 75 pN+ OSCC patients undergoing neck dissection.
• ENE was classified as major (ENEma, >2 mm) or minor (ENEmi, ≤2 mm) based on pathological assessment.
• Survival, locoregional relapse, and distant metastasis rates were analyzed.

Main Results:

• Of 49 patients with ENE, 23 had ENEmi and 26 had ENEma.
• 5-year overall survival was 38% for ENEma, 66% for ENEmi, and 76% for no ENE.
• ENEma was significantly associated with decreased survival and increased risk of distant metastasis (HR: 2.54).

Conclusions:

• Stratifying ENE into minor and major categories is clinically relevant for OSCC prognosis.
• Major ENE (ENEma) is linked to poorer outcomes and may drive distant metastasis.
• New therapeutic strategies targeting distant metastasis control are needed for OSCC patients with ENEma.