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  • Title: Extranodal extension and thickness of metastatic lymph node as a significant prognostic marker of recurrence and survival in head and neck squamous cell carcinoma.
    Author: Kwon M, Roh JL, Lee J, Cho KJ, Choi SH, Nam SY, Kim SY.
    Journal: J Craniomaxillofac Surg; 2015 Jul; 43(6):769-78. PubMed ID: 26027870.
    Abstract:
    PURPOSE: We examined the effect of extranodal extension (ENE) and its thickness (ENET) of metastatic lymph node (LN) on the disease course of patients with head and neck squamous cell carcinoma. METHODS: Data from 438 patients who were initially treated surgically at our center was retrospectively analyzed. ENE presence and ENET were examined in metastatic LN from each patient. Clinicopathologic characteristics, recurrence, and survival were then compared. RESULTS: Of 438 patients, 219 (50%) showed positive nodal status, and ENE was identified in 84 (19.6%). Forty-five of 219 (20.5%) node-positive patients were classified with ENET ≥ 2 mm, which was associated with an increase in both the size and number of positive LN, bilateral cervical involvement, and a higher LN ratio. ENE-positive patients had a higher risk of recurrence and a lower overall survival rate; however, multivariate analysis failed to identify a significant difference in cancer-specific survival (CSS) between those with and those without ENE. On the contrary, ENET ≥ 2 mm was significantly associated with a poor CSS, even in multivariate analysis. CONCLUSION: ENET ≥ 2 mm might be a complementary prognostic marker in CSS estimation for ENE positivity.
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