PMID- 38529341
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240327
IS  - 2378-8038 (Print)
IS  - 2378-8038 (Electronic)
IS  - 2378-8038 (Linking)
VI  - 9
IP  - 2
DP  - 2024 Apr
TI  - Extranodal extension in laryngeal squamous cell carcinoma.
PG  - e1232
LID - 10.1002/lio2.1232 [doi]
LID - e1232
AB  - OBJECTIVE: Although large retrospective database studies have associated 
      extranodal extension (ENE) with worse survival in several head and neck cancers, 
      the prognostic significance of ENE in laryngeal squamous cell carcinoma (LSCC) 
      remains unclear. Our study examines ENE and overall survival (OS) in LSCC. 
      METHODS: The 2006-2017 National Cancer Database was queried for patients with 
      LSCC undergoing surgical resection and neck dissection, with or without adjuvant 
      therapy. Kaplan-Meier and multivariable Cox regression survival analyses were 
      implemented to identify the independent impacts of pathologic nodal (pN) 
      classification and ENE on OS. RESULTS: Of 4208 patients satisfying inclusion 
      criteria, 2343 (55.7%) were pN0/ENE-negative, 1059 (25.2%) were 
      pN1-2/ENE-negative, and 806 (19.2%) were pN1-2/ENE-positive. The 5-year OS of 
      pN0/ENE-negative, pN1-2/ENE-negative, and pN1-2/ENE-positive patients was 62.8%, 
      56.7%, and 32.9%, respectively (p < .001). Among pN1-2/ENE-positive patients 
      undergoing no adjuvant therapy, adjuvant radiotherapy alone, and adjuvant 
      chemoradiotherapy, 5-year OS was 24.1%, 30.7%, and 36.7%, respectively 
      (p < .001). After adjusting for patient demographics, clinicopathologic features, 
      and adjuvant therapy, ENE-positivity was associated with worse OS than 
      ENE-negativity (adjusted hazard ratio [aHR] 1.76, 95% confidence interval [CI] 
      1.53-2.02, p < .001). pN1/ENE-positivity (aHR 1.82, 95% CI 1.31-2.54) and 
      pN2/ENE-positivity (aHR 1.89, 95% CI 1.49-2.40) were associated with worse OS 
      than pN1/ENE-negativity (p < .001). Microscopic (aHR 1.83, 95% CI 1.54-2.18) and 
      macroscopic ENE-positivity (aHR 1.75, 95% 1.35-2.26) were associated with worse 
      OS than ENE-negativity (p < .001). CONCLUSION: ENE-positivity has prognostic 
      significance in LSCC and is associated with worse OS than ENE-negativity. pN 
      classification did not have prognostic significance independent of ENE. ENE 
      should be carefully considered when determining the prognosis of LSCC and 
      selecting adjuvant therapy. LEVEL OF EVIDENCE: 4.
CI  - (c) 2024 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley 
      Periodicals LLC on behalf of The Triological Society.
FAU - Patel, Aman M
AU  - Patel AM
AUID- ORCID: 0000-0003-0794-041X
AD  - Department of Otolaryngology-Head and Neck Surgery Rutgers New Jersey Medical 
      School Newark New Jersey USA.
FAU - Vedula, Sudeepti
AU  - Vedula S
AUID- ORCID: 0000-0003-1058-8816
AD  - Department of Otolaryngology-Head and Neck Surgery Rutgers New Jersey Medical 
      School Newark New Jersey USA.
FAU - Shaari, Ariana L
AU  - Shaari AL
AUID- ORCID: 0000-0003-2611-6418
AD  - Department of Otolaryngology-Head and Neck Surgery Rutgers New Jersey Medical 
      School Newark New Jersey USA.
FAU - Choudhry, Hannaan S
AU  - Choudhry HS
AUID- ORCID: 0000-0003-4941-4629
AD  - Department of Otolaryngology-Head and Neck Surgery Rutgers New Jersey Medical 
      School Newark New Jersey USA.
FAU - Filimonov, Andrey
AU  - Filimonov A
AUID- ORCID: 0000-0002-4285-5862
AD  - Department of Otolaryngology-Head and Neck Surgery Rutgers New Jersey Medical 
      School Newark New Jersey USA.
LA  - eng
PT  - Journal Article
DEP - 20240325
PL  - United States
TA  - Laryngoscope Investig Otolaryngol
JT  - Laryngoscope investigative otolaryngology
JID - 101684963
PMC - PMC10961995
OTO - NOTNLM
OT  - National Cancer Database
OT  - extranodal extension
OT  - laryngeal squamous cell carcinoma
OT  - nodal metastasis
OT  - survival
COIS- The authors declare no conflicts of interest.
EDAT- 2024/03/26 06:45
MHDA- 2024/03/26 06:46
PMCR- 2024/03/25
CRDT- 2024/03/26 03:43
PHST- 2023/11/22 00:00 [received]
PHST- 2024/02/11 00:00 [accepted]
PHST- 2024/03/26 06:46 [medline]
PHST- 2024/03/26 06:45 [pubmed]
PHST- 2024/03/26 03:43 [entrez]
PHST- 2024/03/25 00:00 [pmc-release]
AID - LIO21232 [pii]
AID - 10.1002/lio2.1232 [doi]
PST - epublish
SO  - Laryngoscope Investig Otolaryngol. 2024 Mar 25;9(2):e1232. doi: 
      10.1002/lio2.1232. eCollection 2024 Apr.