TY - JOUR
T1 - Diagnostic challenges and prognostic implications of extranodal extension in head and neck cancer
T2 - a state of the art review and gap analysis
AU - Henson, Christina E.
AU - Abou-Foul, Ahmad K.
AU - Morton, Daniel J.
AU - McDowell, Lachlan
AU - Baliga, Sujith
AU - Bates, James
AU - Lee, Anna
AU - Bonomo, Pierluigi
AU - Szturz, Petr
AU - Nankivell, Paul
AU - Huang, Shao Hui
AU - Lydiatt, William M.
AU - O’Sullivan, Brian
AU - Mehanna, Hisham
N1 - Publisher Copyright:
Copyright © 2023 Henson, Abou-Foul, Morton, McDowell, Baliga, Bates, Lee, Bonomo, Szturz, Nankivell, Huang, Lydiatt, O’Sullivan and Mehanna.
PY - 2023
Y1 - 2023
N2 - Extranodal extension (ENE) is a pattern of cancer growth from within the lymph node (LN) outward into perinodal tissues, critically defined by disruption and penetration of the tumor through the entire thickness of the LN capsule. The presence of ENE is often associated with an aggressive cancer phenotype in various malignancies including head and neck squamous cell carcinoma (HNSCC). In HNSCC, ENE is associated with increased risk of distant metastasis and lower rates of locoregional control. ENE detected on histopathology (pathologic ENE; pENE) is now incorporated as a risk-stratification factor in human papillomavirus (HPV)-negative HNSCC in the eighth edition of the American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC) TNM classification. Although ENE was first described almost a century ago, several issues remain unresolved, including lack of consensus on definitions, terminology, and widely accepted assessment criteria and grading systems for both pENE and ENE detected on radiological imaging (imaging-detected ENE; iENE). Moreover, there is conflicting data on the prognostic significance of iENE and pENE, particularly in the context of HPV-associated HNSCC. Herein, we review the existing literature on ENE in HNSCC, highlighting areas of controversy and identifying critical gaps requiring concerted research efforts.
AB - Extranodal extension (ENE) is a pattern of cancer growth from within the lymph node (LN) outward into perinodal tissues, critically defined by disruption and penetration of the tumor through the entire thickness of the LN capsule. The presence of ENE is often associated with an aggressive cancer phenotype in various malignancies including head and neck squamous cell carcinoma (HNSCC). In HNSCC, ENE is associated with increased risk of distant metastasis and lower rates of locoregional control. ENE detected on histopathology (pathologic ENE; pENE) is now incorporated as a risk-stratification factor in human papillomavirus (HPV)-negative HNSCC in the eighth edition of the American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC) TNM classification. Although ENE was first described almost a century ago, several issues remain unresolved, including lack of consensus on definitions, terminology, and widely accepted assessment criteria and grading systems for both pENE and ENE detected on radiological imaging (imaging-detected ENE; iENE). Moreover, there is conflicting data on the prognostic significance of iENE and pENE, particularly in the context of HPV-associated HNSCC. Herein, we review the existing literature on ENE in HNSCC, highlighting areas of controversy and identifying critical gaps requiring concerted research efforts.
KW - extranodal extension
KW - head and neck cancer
KW - head and neck pathology
KW - head and neck squamous cell carcinoma
KW - locally advanced head and neck cancer
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U2 - 10.3389/fonc.2023.1263347
DO - 10.3389/fonc.2023.1263347
M3 - Review article
C2 - 37799466
AN - SCOPUS:85173512958
SN - 2234-943X
VL - 13
JO - Frontiers in Oncology
JF - Frontiers in Oncology
M1 - 1263347
ER -