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Author Notes:

Correspondence: Jonathan J. Beitler, MD, MBA, FACR, FASTRO, Department of Radiation Oncology, Winship Cancer Institute of Emory University, 1365 Clifton Road, Atlanta, GA 30322, (404) 778-3473, jjbeitl@emory.edu


Research Funding:

Research reported in this publication was supported in part by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University and NIH/NCI under award number P30CA138292.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Otorhinolaryngology
  • Surgery
  • extranodal extension
  • ENE
  • HPV
  • p16
  • oropharynx cancer
  • Squamos cell carcinoma
  • Extra-capsular spread
  • Computed tomography
  • Advanced head
  • Neck cancer
  • Risk
  • Chemotherapy
  • Radiotherapy
  • Accuracy
  • Likelihood

Prognostic value of radiographically defined extranodal extension in human papillomavirus-associated locally advanced oropharyngeal carcinoma

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Journal Title:

Head and Neck: Journal of the Sciences and Specialties of the Head and Neck


Volume 41, Number 9


, Pages 3056-3063

Type of Work:

Article | Post-print: After Peer Review


Background Pathologic extranodal extension (ENE) has traditionally guided the management of head and neck cancers. The prognostic value of radiographic ENE (rENE) in HPV-associated oropharyngeal squamous cell carcinoma (HPV+OPX) is uncertain. Methods HPV+OPX patient with adequate pre-treatment radiographic nodal evaluation, from a single institution were analyzed. rENE status was determined by neuroradiologists’ at time of diagnosis. Distant metastasis-free survival (DMFS), overall survival (OS), locoregional recurrence-free survival (LRFS) and were estimated using Kaplan-Meier methods. Cox proportional hazards models were fit to assess the impact of rENE on survival endpoints. Results 168 patients with OPX+SCC diagnosed between April 2008 and December 2014 were included for analysis with median follow-up of 3.3 years. Eighty-eight percent of patients received concurrent chemoradiotherapy. rENE was not prognostic; its presence in HPV+OPX patients did not significantly impact OS, LRFS, or DMFS. Conclusions In patients with HPV+OPX, rENE was not significantly associated with OS, LRFS, or DMFS.

Copyright information:

© 2019 John Wiley & Sons, Inc. All rights reserved.

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