Meta-analysis of the prognostic significance of perinodal spread in head and neck squamous cell carcinomas (HNSCC) patients

Dünne, Anja A.; Müller, Helge; Eisele, David W.; Kessel, Kerstin A.; Moll, Roland; Werner, Jochen A.

doi:10.1016/j.ejca.2006.01.062

Cited by 101 publications

(86 citation statements)

References 27 publications

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“…Two meta-analyses by Dünne et al [16] and Mermod et al [17] confirmed these results. Dunne et al [16] analysed 115 studies, selecting 9 of them and showing that ECS negatively impacts the 5-year survival (odds ratio, OR = 2.7).…”

Section: Extracapsular Spread For Non-viral-induced Hnsccsupporting

confidence: 71%

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Pros and Cons of the New Edition of TNM Classification of Head and Neck Squamous Cell Carcinoma

Denaro

Russi

Merlano³

2018

Oncology

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The TNM classification is a worldwide standard staging system used to define the extent of cancer and is a major prognostic factor in predicting the outcome of patients. The TNM Classification of Malignant Tumours, 8th edition, has been used since January 1, 2018. In the area of head and neck cancer major modifications were produced: important updated T and N modification for oral cavity and nasopharyngeal cancer, the introduction of clinical and pathological stages for neck disease, and a new HPV-16-positive HNSCC classification. While until a few years ago the TNM staging system classified prognostic risk groups based on tumour size, the 8th edition responds to the need to categorize the prognosis of patients with similarly sized tumours but with very different clinical and biological behaviour. This review details TNM changes and the clinical need for these modifications, valuating possible limits in daily applicability.

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Section: Extracapsular Spread For Non-viral-induced Hnsccsupporting

confidence: 71%

“…Dunne et al [16] analysed 115 studies, selecting 9 of them and showing that ECS negatively impacts the 5-year survival (odds ratio, OR = 2.7).…”

Section: Extracapsular Spread For Non-viral-induced Hnsccmentioning

confidence: 99%

Pros and Cons of the New Edition of TNM Classification of Head and Neck Squamous Cell Carcinoma

Denaro

Russi

Merlano³

2018

Oncology

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“…In node positive patients, an additional poor prognostic sign is the presence of extracapsular spread of tumor outside the confines of the lymph node which occurs in >60% of nodes larger than 3 cm and up to 23% of nodes smaller than 1.0 cm [41]. In a recent meta-analysis, patients with extracapsular spread were 2.7 times (95%CI, 2.0-3.7) more likely to die from regional and distant recurrence within 5 years compared to patients without extranodal spread [42]. • Due to the increased mortality associated with regional neck metastasis, HNSCC patients are evaluated at the time of initial presentation for cervical adenopathy by both physical examination and radiographic imaging.…”

Section: Mechanisms Of Lymphatic Spread and Regional Metastasismentioning

confidence: 97%

Mechanisms of Tumor Growth and Metastasis in Head and Neck Squamous Cell Carcinoma

Walsh

Lathers

Angela

et al. 2007

Curr. Treat. Options in Oncol.

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The formation and progression of head and neck squamous cell carcinoma (HNSCC) is multisystemic and involves the immune system, vascularization, and dissemination. Immune involvement includes the subversion of anti-tumor defenses. Vascularization involves both angiogenesis and vasculogenesis. Dissemination involves local tumor invasion as well as distant metastasis through processes including angiogenesis and lymphangiogenesis. Current studies in the dysregulation of various processes, including genetic stability, angiogenesis, lymphangiogenesis, immune regulation, and immune function, are opening opportunities for the development of targeted tumor therapies. The interrelationship of these processes in HNSCC development will be explored in this review.

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“…A number of studies (11,17,18) have suggested that a carcinoma, which infiltrates and spreads beyond the LN capsule, represents a more aggressive disease that is related to the genetic nature of the tumor cell or to the pathological compliance of the hosts' immune system rather than a late presentation. Several studies have also reported on the importance of differing extents of ENE that is associated with a poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…The authors concluded that the presence of ENE in the neck dissections had a negative impact on survival (summarized odds ratio: 2.7, 95.0% confidence interval: 2.2−3.4) (11). Thus, ENE is widely regarded as a pathological marker of a poor prognosis in patients with HNSCC (11)(12)(13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of surgical extranodal extension in head and neck squamous cell carcinoma patients

Matsumoto

Mori

Matsumura

et al. 2017

Japanese Journal of Clinical Oncology

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Background: Lymph node metastasis with extranodal extension represents one of the most important adverse prognostic factors for survival in patients with head and neck squamous cell carcinoma. We propose that extranodal extension occurs to differing extents. The aim of this study was to determine the prognostic significance of extranodal extension in patients with head and neck squamous cell carcinoma. Methods: Two hundred and ninety-eight patients with head and neck squamous cell carcinoma who underwent surgical resection and neck dissection were included. Cervical lymph nodes were classified into four categories: (i) pathological N negative, (ii) extranodal extension negative, (iii) non-surgical extranodal extension and (iv) surgical extranodal extension. Results: Lymph node metastases were detected in 67.1% of laryngeal/hypopharyngeal cancer patients and 52.7% of oral cancer patients. The 3-year disease-specific survival rates for patients in the pathological N negative, extranodal extension negative, non-surgical extranodal extension and surgical extranodal extension groups were 90.9%, 79.6%, 63.8% and 48.3%, respectively. In laryngeal/hypopharyngeal cancer patients, surgical extranodal extension was associated with a significantly poorer disease-specific survival than a pathological N negative, extranodal extension negative or non-surgical extranodal extension status. In oral cancer patients, no significant differences were observed between the non-surgical and surgical extranodal extension groups. However, non-surgical extranodal extension was associated with a poorer disease-specific survival than a pathological N negative or extranodal extension negative status. Conclusions: Surgical extranodal extension was a poor prognostic factor in patients with head and neck squamous cell carcinoma. The prognostic significance of surgical extranodal extension differed between laryngeal/hypopharyngeal and oral cancer patients. The clinical significance of surgical extranodal extension was much greater for patients with laryngeal/hypopharyngeal cancer than oral cancer.

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Meta-analysis of the prognostic significance of perinodal spread in head and neck squamous cell carcinomas (HNSCC) patients

Cited by 101 publications

References 27 publications

Pros and Cons of the New Edition of TNM Classification of Head and Neck Squamous Cell Carcinoma

Pros and Cons of the New Edition of TNM Classification of Head and Neck Squamous Cell Carcinoma

Mechanisms of Tumor Growth and Metastasis in Head and Neck Squamous Cell Carcinoma

Prognostic significance of surgical extranodal extension in head and neck squamous cell carcinoma patients

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