ArticleFrontiers in oncology2022
Prognostic Value of Radiological Extranodal Extension Detected by Computed Tomography for Predicting Outcomes in Patients With Locally Advanced Head and Neck Squamous Cell Cancer Treated With Radical Concurrent Chemoradiotherapy.
Article in Frontiers in oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 27 citations in OpenAlex.
- Correlation between imaging-detected and pathological extranodal extension in a randomised trial in Human Papillomavirus-positive oropharyngeal cancer.British journal of cancer · 2026Trial
- CT-based Extranodal Extension for Nodal Staging and Prognostic Stratification in Surgically Resectable Esophageal Squamous Cell Carcinoma.Radiology. Imaging cancer · 2026Observational
- Imaging-detected extranodal extension in head and neck cancer: clinical implications, diagnostic criteria, and the potential of photon-counting detector CT.Japanese journal of radiology · 2026Review
- Prognostic impact of extranodal extension in oral cavity cancers: a retrospective analysis and implications for treatment intensification.Journal of cancer research and clinical oncology · 2025Article
- Lymph node or lymphoid aggregate? Impact on cancer resection quality, clinical prognosis, and tumor staging.Histology and histopathology · 2025Review
- Radiological extranodal extension in head and neck cancers: current evidence and challenges in imaging detection and prognostic impact.BJR open · 2025Review
- Comprehensive Guide to Randomized Controlled Trials in Radiology: Everything You Need to Know.The Indian journal of radiology & imaging · 2025Article
- Advances and residual knowledge gaps in the neck management of head and neck squamous cell carcinoma patients with advanced nodal disease undergoing definitive (chemo)radiotherapy for their primary.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Review
- Editorial: Site specific imaging guidelines in head & neck, and skull base cancers.Frontiers in oncology · 2024Article
- CT-Based Screening for Pulmonary Metastases in Head and Neck Squamous Cell Cancers: Diagnostic Accuracy and Cost Comparison with PET-CECT.Indian journal of surgical oncology · 2023Article
- Definitive Radiotherapy in Locally Advanced Head and Neck Squamous Cell Cancer with Clinical Extranodal Extension.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2023Article
- Article
- Assessing the Risk of Adjuvant Radiotherapy Initiation Delays With Social Support Surveys.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2023Article
- Diagnostic challenges and prognostic implications of extranodal extension in head and neck cancer: a state of the art review and gap analysis.Frontiers in oncology · 2023Review
- Response assessment of post-treatment head and neck cancers to determine further management using NI-RADS (Neck Imaging Reporting and Data System): a subgroup analysis of a randomized controlled trial.Frontiers in oncology · 2023Article
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22 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Objective: Extra Nodal Extension (ENE) assessment in locally advanced head and neck cancers (LAHNCC) treated with concurrent chemo radiotherapy (CCRT) is challenging and hence the American Joint Committee on Cancer (AJCC) N staging. We hypothesized that radiology-based ENE (rENE) may directly impact outcomes in LAHNSCC treated with radical CCRT. Materials and Methods: Open-label, investigator-initiated, randomized controlled trial (RCT) (2012-2018), which included LAHNSCC planned for CCRT. Patients were randomized 1:1 to radical radiotherapy (66-70 grays) with concurrent weekly cisplatin (30 mg/m Results: A total of 244 (68.9%) patients had radiologically metastatic nodes (rN), out of which 140 (57.3%) had rENE. Distribution of rENE was balanced in the two study groups CRT or NCRT (p-value 0.412). The median follow-up period was 39 months (ranging from 35.5 to 42.8 months). Complete response (CR) was seen in 204 (57.6%); incomplete response (IR), i.e., partial response plus stable disease (PR + SD), in 126 (35.6%); and progressive disease (PD) in 24 (6.8%). rENE-positive group had poor survival compared to rENE-negative group 3-year OS (46.7% vs. 63.6%), poor DFS (48.8% vs. 87%), and LRRFS (39.9% vs. 60.4%). rENE positive had 1.71 times increased risk of IR than rENE negative. Overall stage, site, clinical metastatic node (cN), response, and rENE were the significant factors for predicting OS, DFS, and LRRFS on univariate analysis. After making adjustment on multivariate analysis, rENE was an independent prognostic factor for DFS and trending to be significant for OS. Conclusion: Pre-treatment rENE is an independent prognostic marker for survival in patients with LAHNSCC treated radically with CCRT that can be used as a potential predictive marker for response to treatment and hence stratify patients into responders vs. non-responders. We propose the mahajan rENE grading system applicable on CT, magnetic resonance imaging, positron emission tomography-contrast-enhanced CT, and ultrasound.
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