SynthesisHead and neck pathology2021
Histopathological Definitions of Extranodal Extension: A Systematic Review.
Synthesis in Head and neck pathology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- The Impact of Histopathological Features on the Prognosis of Oral Squamous Cell Carcinoma: A Comprehensive Review and Meta-Analysis.Frontiers in oncology · 2021Pooled it
- [Clinical Significance of Extranodal Extension in Non-small Cell Lung Cancer: Current Status and Future Prospects].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2026Review
- Prognostic significance of extracapsular extension in patients with non-small cell lung cancer following neoadjuvant chemoimmunotherapy: a retrospective cohort study.Frontiers in immunology · 2026Article
- Survival Trends Associated With Histopathological Risk Factors in Oral Squamous Cell Carcinoma.International journal of dentistry · 2026Article
- The extent of extranodal extension as a prognostic indicator in papillary thyroid cancer.Archives of endocrinology and metabolism · 2025Article
- ESR Bridges: imaging and treatment of extranodal spread in head and neck cancer-a multidisciplinary view.European radiology · 2025Article
- Extranodal extension in laryngeal squamous cell carcinoma.Laryngoscope investigative otolaryngology · 2024Article
- Article
- MMP14 expression levels accurately predict the presence of extranodal extensions in oral squamous cell carcinoma: a retrospective cohort study.BMC cancer · 2023Article
- Inter- and Intrarater Reliability and Agreement Among Danish Head and Neck Pathologists Assessing Extranodal Extension in Lymph Node Metastases from Oropharyngeal Squamous Cell Carcinomas.Head and neck pathology · 2022Article
- Prognostic impact of extranodal extension (ENE) in surgically managed treatment-naive HPV-positive oropharyngeal squamous cell carcinoma with nodal metastasis.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2022Article
- Differential expression of podoplanin in metastatic lymph node is associated with extranodal extension in oropharyngeal cancer.Scientific reports · 2022Article
- Extranodal Extension in Bilateral Cervical Metastases: A predictor of Undesirable Survival Outcomes despite Aggressive Salvage Treatment in Oral Cancer Patients.Journal of Cancer · 2021Article
- Lymph nodes in health and disease - A pathologist's perspective.Journal of oral and maxillofacial pathology : JOMFPArticle
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Extranodal extension (ENE) is a very strong prognostic factor in head and neck squamous cell carcinoma. However, significant variance in reported incidence of ENE suggests discordance in perception of ENE among pathologists. This study aims to map the different definitions of histopathological ENE used in the literature. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. Guided by the research question: "How is histopathological ENE defined?" the databases Medline, Embase, and Cochrane were systematically searched. All retrieved studies were reviewed and qualitatively analyzed. Three categories of existing definitions were formed. The systematic literature search yielded 1786 studies after removal of duplicates. Nine hundred and thirty-four full text articles were assessed for inclusion and 44 unique ENE definitions were identified and categorized 1-3; (1) simple definitions only describing a breach in the capsule (48%), (2) definitions also including a description of the perinodal tissue (43%), and (3) definitions adding a description of a specific reaction in the perinodal structure (9%). No consensus definition of ENE exists, but based on the level of details in the identified definitions, three overall categories of ENE definitions were established.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.