ReviewFrontiers in oncology2023
Diagnostic challenges and prognostic implications of extranodal extension in head and neck cancer: a state of the art review and gap analysis.
Review in Frontiers in oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Clinical predictive models for recurrence and survival in treated laryngeal and hypopharyngeal cancer: a systematic review and meta-analysis.Frontiers in oncology · 2024Pooled it
- Article
- Prognostic value of the number of imaging-detected lymph node metastases diagnosed by combined FDG-PET/CT and Node-RADS in HPV-associated oropharyngeal carcinoma.European radiology · 2026Article
- Article
- Article
- CT-based Extranodal Extension for Nodal Staging and Prognostic Stratification in Surgically Resectable Esophageal Squamous Cell Carcinoma.Radiology. Imaging cancer · 2026Observational
- Lymph Node Metastasis in Head and Neck Squamous Cell Carcinoma: Evolving Prognostic Markers, Molecular Insights, and Implications for Precision Staging.Diagnostics (Basel, Switzerland) · 2026Review
- Association Between Nutritional Status and Extranodal Extension of Lymph Node Metastases in Head and Neck Squamous Cell Cancers.Nutrients · 2026Article
- Novel Immunotherapeutic Approaches for Patients with Head and Neck Cutaneous Squamous Cell Carcinoma.Oncology research · 2026Review
- Pattern of Mandibular Bone Invasion as a Prognostic Factor.Diagnostics (Basel, Switzerland) · 2025Article
- Tumor-Infiltrating Lymphocytes Predict Extranodal Extension and Prognosis in Regionally Advanced Oral Cavity Cancer.Diagnostics (Basel, Switzerland) · 2025Article
- Clinical value of the worst pattern of invasion in predicting extranodal extension in oral squamous cell carcinoma.Discover oncology · 2025Article
- ESR Bridges: imaging and treatment of extranodal spread in head and neck cancer-a multidisciplinary view.European radiology · 2025Article
- Radiological extranodal extension in head and neck cancers: current evidence and challenges in imaging detection and prognostic impact.BJR open · 2025Review
- Review
Corrections and comments
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Authors and funding
14 authors at 10 institutions in 6 countries.
Funding
Abstract
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.
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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.