Prognostic value of radiographic extracapsular extension in locally advanced head and neck XXXX .

@entity1 @entity5 @entity1544 @entity1828 @entity1349
OBJECTIVES: We investigated associations between radiographic evidence of nodal extracapsular extension ( @entity1828 ) and outcomes for locally advanced head and neck @entity1544 (LAHNC). MATERIALS AND METHODS: We conducted a single-institution retrospective study of 258 consecutive LAHNC @entity1 with accessible pretreatment contrast-enhanced neck CT scans, who completed definitive or adjuvant radiation therapy. All scans were reviewed by an expert head and neck radiologist for evidence of @entity1828 . Kaplan-Meier and Cox regression multivariate analyses (MVA) were performed to evaluate the impact of @entity1828 on @entity1349 ( @entity1349 ), progression free survival (PFS), distant control (DC), and locoregional control (LRC). RESULTS: One-hundred forty @entity1 were @entity1828 -positive and 118 were @entity1828 -negative. The @entity1828 -positive cohort had more cN3 disease (11.6% vs. 0.8%) and heavier smoking histories (60.0% vs. 44.9% with    10-pack-years). The @entity1828 -positive cohort had significantly worse 3-year @entity1349 (64.3% vs. 82.8%, p=0.002), PFS (58.9% vs. 76.0%, p=0.001), DC (72.3% vs. 90.6%, p<0.001), and LRC (75.9% vs. 89.8%, p=0.002). On MVA, @entity1828 independently predicted for worse @entity1349 , PFS, DC, and LRC for LAHNC overall. On subset analysis of @entity5 , @entity1828 was not a significant prognosticator. CONCLUSION: For all sites of LAHNC, except @entity5 , presence of @entity1828 independently predicts for worse disease control and survival. Further studies are needed to validate these findings and demonstrate whether @entity1828 may be considered for risk-stratifying @entity1 for clinical trial design and treatment decisions.
