The Prognostic Value of Pathological Extranodal Extension and Staging Change According to the 8th Edition Pathologic Staging Modifications for Head and Neck Cancer
Mustafa Korkmaz1, Melek Karakurt Eryilmaz1, Mustafa Karaagac11Department of Medical Oncology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
Objectives: We aimed to determine the prognostic value of pathological extranodal extension (pENE) and to evaluate the stage change by restaging according to the 8th edition of the AJCC staging system (AJCC 8) based on the addition of pENE in head and neck cancer (HNC). Methods: This study involved 30 HNC patients with lypmh node metastasis who staged according to AJCC 7 underwent surgery and neck dissection. Results: The median age of patients was 57 years, and 86.7% were male patients. Twenty patients (66.7%) were pENE+, 10 patients (33.3%) were pENE-. After re-staging based on the presence of pENE according to the AJCC 8 criteria, the TNM stage of 20 patients were up-staged due to up-staging in pN stage. One patient (3.3%) classified as pNI according to the AJCC 7 criteria was up-staged to pNIIb. Similarly, 1 patient (3.3%) classified as pNI, 1 patient (3.3%) classified as pNIIa, 3 patients (10%) classified as pNIIb, and 14 patients (46.7%) classified as pNIIc by AJCC 7 were upstaged pNIIIb. Median disease-free survival (DFS) and median overall survival (OS) were 16.6 months and 32.7 months, respectively. The pENE+ patients had shorter median DFS and median OS than those with pENE- (DFS: 9.6 vs. 22.2 months, p=0.24 and OS: 24.1 vs. 32.7 months, p=0.95, respectively), but not statistically significant. Conclusion: The incorporating of pENE to N classification up-staged the TNM stage. In our study, although pENE could not be shown as a statistically significant prognostic marker, the presence of pENE would contribute to the improvement of survival as it would increase the number of patients requiring adjuvant therapy. Therefore pENE indirectly would be appropriate to consider as a prognostic factor. Keywords: Head and neck cancers, extranodal extension, prognosis
Cite This Article
Korkmaz M, Karakurt Eryilmaz M, Karaagac M. The Prognostic Value of Pathological Extranodal Extension and Staging Change According to the 8th Edition Pathologic Staging Modifications for Head and Neck Cancer. EJMI. 2021; 5(4): 486-490
Corresponding Author: Mustafa Korkmaz