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Updated: Sep 15, 2025

A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma
Published on: January 5, 2017
Impact of Extranodal Extension in Metastatic Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Systematic
Andrea Costantino1, Gian Marco Pace2,3, Camilla Zimello2,3
1Department of Otolaryngology - Head and Neck Surgery, Celebration, Florida, USA.
Objective:
The aim of this study is to analyze the impact of extranodal extension (ENE) on survival outcomes for patients with metastatic cutaneous head and neck squamous cell carcinoma (cHNSCC).
Methods:
The pooled hazard ratios (HRs) and the 95% confidence interval (CI) were calculated to define the impact of ENE on overall survival (OS) and disease-free survival (DFS).
Results:
A total of 2076 patients (males: 84.4%) with a median age of 73.3 years were included. The incidence of ENE was 65.6% (N = 1299/1979). The median follow-up time was 38.4 months (95% CI: 21-38.4). The estimated pooled HRs were 1.31 (95% CI: 0.72-2.39; p = 0.28) and 1.80 (95% CI: 0.53-6.10; p = 0.22) for OS and DFS, respectively.
Conclusions:
ENE may not be a reliable prognostic factor in metastatic cHNSCC. Further prospective studies are needed to refine risk stratification and improve the current nodal classification system.
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