Evidence map›Paper›PMID 41897588›Full record

ReviewDiagnostics (Basel, Switzerland)2026

Lymph Node Metastasis in Head and Neck Squamous Cell Carcinoma: Evolving Prognostic Markers, Molecular Insights, and Implications for Precision Staging.

Andrés Coca-Pelaz, Ehab Y Hanna, Orlando Guntinas-Lichius, Luiz P Kowalski, Juan Pablo Rodrigo, Robert P Takes, Marc Hamoir, Remco de Bree, Francisco J Civantos, K Thomas Robbins and 4 more

Abstract readReview
In one paragraph

Review in Diagnostics (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Andrés Coca-PelazDepartment of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, 33011 Oviedo, Spain.ORCID 0000-0003-1363-8559
Ehab Y HannaDepartment of Head & Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Orlando Guntinas-LichiusDepartment of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany.ORCID 0000-0001-9671-0784
Luiz P KowalskiHead and Neck Surgery and Otorhinolaryngology Department, A C Camargo Cancer Center, Sao Paulo 01509-010, Brazil.ORCID 0000-0002-0481-156X
Juan Pablo RodrigoDepartment of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, ISPA, IUOPA, CIBERONC, 33011 Oviedo, Spain.ORCID 0000-0003-3063-0890
Robert P TakesDepartment of Otolaryngology, Head and Neck Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
Marc HamoirDepartment of Otolaryngology, Head & Neck Surgery, St Luc University Hospital, King Albert II Cancer Institute, 1200 Brussels, Belgium.ORCID 0000-0001-8547-2768
Remco de BreeDepartment of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.ORCID 0000-0001-7128-5814
Francisco J CivantosDepartment of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA.
K Thomas RobbinsDepartment of Otolaryngology Head Neck Surgery, SIU School of Medicine, Southern Illinois University, Springfield, IL 62702, USA.
Carlos SuárezFaculty of Medicine, University of Oviedo, 33003 Oviedo, Spain.
M P SreeramDepartment of Head and Neck Oncology, Sri Shankara Cancer Foundation, Bangalore 560004, India.ORCID 0000-0002-4050-9106
Karthik RaoDepartment of Head and Neck Oncology, Sri Shankara Cancer Foundation, Bangalore 560004, India.ORCID 0000-0002-1420-7366
Alfio FerlitoInternational Head and Neck Scientific Group, 35100 Padua, Italy.ORCID 0000-0002-8247-8002

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Lymph node metastasis (LNM) is one of the most powerful prognostic determinants in head and neck squamous cell carcinoma (HNSCC). The extent and pattern of nodal involvement critically influence staging accuracy, therapeutic decision-making, and patient outcomes. However, the biological and clinical implications of nodal disease remain complex and continue to evolve. We aim to synthesize current clinical and translational evidence regarding the prognostic and therapeutic impact of LNM in HNSCC and to highlight emerging trends relevant to precision staging. A narrative review was conducted through a structured literature search in PubMed and Scopus (2008-2025), with emphasis on studies published in the last five years. Meta-analyses, large cohort studies, and evidence-based guidelines addressing prognostic factors, biological mechanisms, and management strategies were critically appraised. LNM is consistently associated with reduced overall and disease-free survival across major head and neck subsites. Key independent prognostic variables include the number of metastatic nodes, extranodal extension, and involved cervical levels. Recent advances, such as refinements in the AJCC 8th edition, sentinel lymph node mapping, high-resolution imaging, and molecular profiling, have improved early detection and refined risk stratification. LNM remains central to prognostic evaluation and treatment selection in HNSCC. Integrating biological insights with molecular diagnostics and advanced imaging will be essential to achieving precision staging and individualized therapeutic strategies.

Indexed as

extranodal extensionhead and neck cancerlymph node metastasisprognosissquamous cell carcinomasurvival

Identifiers

PMID41897588
PMCPMC13024878

What OpenQuestion holds

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Registered trials

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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.