Remco de Bree1,2, Redina Ljumanovic3, Marieke J Hazewinkel4, Birgit I Witte5, Jonas A Castelijns6. 1. Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands. 2. Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, UMC Utrecht, Utrecht, The Netherlands. 3. Department of Radiology, Advent Hospital Willemstad, Curaçao, The Netherlands. 4. Department of Radiology, Medisch Spectrum Twente, Enschede, The Netherlands. 5. Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands. 6. Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Different clinical high-risk factors for the development of distant metastases have been identified but not tested in the same cohort of patients with head and neck squamous cell carcinoma (HNSCC). METHODS: In 145 patients with previously identified clinical high risk factors, the presence of extranodal spread (ENS) and matted node on pretreatment CT (n = 96) and/or MRI (n = 111) were determined. RESULTS: Of 145 patients, ENS was detected in 87 patients (60.0%) and matted nodes in 53 patients (36.6%). Kaplan-Meier curves for presence or absence of ENS (on CT and/or MRI) and matted nodes (on CT) differ significantly. In a Cox regression analysis, only ENS was a significant risk factor (hazard ratio [HR] = 3.3; 95% confidence interval [CI] = 2.0-5.5; p < .001). CONCLUSION: In patients with high-risk HNSCC with clinically (palpably or radiologically) ENS and matted nodes, both determined radiologically, are high risk factors for development of distant metastases.
BACKGROUND: Different clinical high-risk factors for the development of distant metastases have been identified but not tested in the same cohort of patients with head and neck squamous cell carcinoma (HNSCC). METHODS: In 145 patients with previously identified clinical high risk factors, the presence of extranodal spread (ENS) and matted node on pretreatment CT (n = 96) and/or MRI (n = 111) were determined. RESULTS: Of 145 patients, ENS was detected in 87 patients (60.0%) and matted nodes in 53 patients (36.6%). Kaplan-Meier curves for presence or absence of ENS (on CT and/or MRI) and matted nodes (on CT) differ significantly. In a Cox regression analysis, only ENS was a significant risk factor (hazard ratio [HR] = 3.3; 95% confidence interval [CI] = 2.0-5.5; p < .001). CONCLUSION: In patients with high-risk HNSCC with clinically (palpably or radiologically) ENS and matted nodes, both determined radiologically, are high risk factors for development of distant metastases.
Authors: Carlos Miguel Chiesa-Estomba; Maria Soriano-Reixach; Ekhiñe Larruscain-Sarasola; Jon Alexander Sistiaga-Suarez; Jose Angel González-García; Amaia Sanchez-Martin; Laura Basterretxea-Badiola; Naiara Sagastibelta; Xabier Altuna-Mariezcurrena Journal: Eur Arch Otorhinolaryngol Date: 2021-02-07 Impact factor: 2.503