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Significance of Preoperative Imaging-Detected Extranodal Extension in Pathological Extranodal Extension-Positive Head
Yuta Hoshi1,2, Hirofumi Kuno3, Shingo Sakashita4
1Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Chiba, Japan.
Background:
The Head and Neck Cancer International Group (HNCIG) recently proposed standardized classifications for imaging-detected extranodal extension (iENE) and pathological ENE (pENE). We evaluated the prognostic value of iENE in pENE-positive head and neck squamous cell carcinoma (HNSCC) treated with postoperative chemoradiotherapy (CRT).
Methods:
Patients with pENE-positive HNSCC who underwent postoperative CRT were retrospectively analyzed. iENE and pENE were re-classified using HNCIG criteria. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using Kaplan-Meier and Cox proportional hazards models.
Results:
Ninety-two patients were included. iENE grades 2-3 were associated with significantly worse outcomes than grades 0-1 (3-year RFS: 68.5% vs. 31.5%, log-rank p = 0.0002; 3-year OS: 85.0% vs. 63.2%, log-rank p = 0.02). In multivariable analysis, iENE was the only independent prognostic factor for RFS and OS.
Conclusion:
Preoperative iENE is a prognostic factor in pENE-positive HNSCC after postoperative CRT, with grades 2-3 identifying a very high-risk population.
