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Radiologic extranodal spread and matted nodes: Important predictive factors for development of distant metastases in patients with high‐risk head and neck cancer
Author(s) -
de Bree Remco,
Ljumanovic Redina,
Hazewinkel Marieke J.,
Witte Birgit I.,
Castelijns Jonas A.
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24257
Subject(s) - hazard ratio , confidence interval , head and neck squamous cell carcinoma , head and neck cancer , medicine , proportional hazards model , cohort , risk factor , head and neck , radiology , oncology , cancer , surgery
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. © 2015 Wiley Periodicals, Inc. Head Neck 38 : E1452–E1458, 2016