Differential expression of podoplanin in metastatic lymph node is associated with extranodal extension in oropharyngeal cancer

Lee, Hye Ran; Roh, Jin; Gu, Ga Young; Lee, Ju Ho; Shin, Yoo Seob; Jang, Jeon Yeob; Kim, Chul‐Ho

doi:10.1038/s41598-022-07794-0

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…Indeed, the hypothesis that the molecular determinants of ECS are present in the primary tumor is supported by recent studies [58][59][60][61]. Meanwhile, several studies have investigated the role of tumor microenvironment in ECS tumor formation [50,57,[62][63][64] and suggested that phenotypic changes occur from intranodal metastasis to ECS, rather than the intrinsic properties of the primary tumor.…”

Section: Discussionmentioning

confidence: 96%

Extra-Capsular Spread of Lymph Node Metastasis in Oral, Oropharyngeal and Hypopharyngeal Cancer: A Comparative Subsite Analysis

Kang,

Park,

Park

et al. 2024

Cancers

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Background: The extra-capsular spread (ECS) of lymph node metastasis (LNM) is a hallmark of aggressive primary tumor phenotype in head and neck cancer (HNC); however, the factors influencing ECS are poorly understood. Patients and Methods: This was a retrospective study, including 190 cases of oral tongue cancer (OTC), 148 cases of oropharyngeal cancer (OPC) (118 HPV-positive and 30 HPV-negative), and 100 cases of hypopharyngeal cancer (HPC). Tumor dimension, tumor biological variables (lymphovascular/perineural invasion and histologic grade), and LNM variables (LNM number and size) were analyzed according to the presence of ECS using multivariable logistic regression and receiver operating characteristic (ROC) curve analyses. Results: LNM variables were significant factors for ECS in all subsites of HNC (p < 0.05), except HPV-positive OPC. In OTC, tumor dimensional variables were significantly related to ECS (p < 0.01). Meanwhile, in OPC and HPC, neither the primary tumor dimension nor the T status were significant factors for ECS occurrence. The predictability of ECS by ROC curve using multiple variables was 0.819 [95% confidence interval: 0.759–0.878] in OTC, 0.687 [0.559–0.815] in HPV-positive OPC, 0.823 [0.642–1.000] in HPV-negative OPC, and 0.907 [0.841–0.973] in HPC. Conclusion: LNM variables were correlated with ECS occurrence for most HNC subsites, and site-dependent primary tumor characteristics might contribute differentially to the ECS development of LNM in HNC.

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Section: Discussionmentioning

confidence: 96%

Extra-Capsular Spread of Lymph Node Metastasis in Oral, Oropharyngeal and Hypopharyngeal Cancer: A Comparative Subsite Analysis

Kang,

Park,

Park

et al. 2024

Cancers

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Sensitivity and Specificity of Extranodal Extension: Unlocking One of the Strongest Prognostic Factors in Head and Neck Cancer

Huang

Busca

et al. 2023

Critical Issues in Head and Neck Oncology

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Extranodal extension (ENE) represents a spectrum of tumor invasion beyond the nodal capsule. The earliest stages of ENE can only be detected under the microscope (pathologic-ENE, pENE). As ENE progresses, it can eventually become visible on imaging (radiologic-ENE, rENE). When ENE further advances to invade skin and/or underlining structures causing fixation and neurovascular impairment, it becomes clinically evident (clinical-ENE, cENE). pENE is the most objective and sensitive way of identifying ENE while subjectivity exists for rENE and cENE detection. Hence, pENE often serves as a gold standard for assessing the accuracy of rENE and cENE. The sensitivity and specificity of rENE for pENE depends on the level of certainty that a radiologist has adopted for declaration. If unequivocal radiologic signs are used for declaration, the specificity of rENE for pENE is very high. Unequivocal rENE carries prognostic significance beyond traditional cN classification for both viral-related and unrelated head and neck cancer, and can serve an important role for clinical care and risk stratification. For clinical care, such as triaging HPV-positive oropharyngeal cancer to surgery vs radiotherapy, a relatively modest level of certainty (>50%) may be used for rENE declaration before treatment assignment to achieve high sensitivity and avoid potential triple-modality treatment. For staging, a high level of certainty (>90%) should be used for rENE declaration to preserve its prognostic importance and avoid dilution due to equivocal cases, or the inclusion of minimal ENE lacking importance due to mitigation by contemporary treatments. Standardization of definitions and radiology reporting templates should facilitate the adoption of rENE into clinical care and staging.

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Differential expression of podoplanin in metastatic lymph node is associated with extranodal extension in oropharyngeal cancer

Cited by 2 publications

References 27 publications

Extra-Capsular Spread of Lymph Node Metastasis in Oral, Oropharyngeal and Hypopharyngeal Cancer: A Comparative Subsite Analysis

Extra-Capsular Spread of Lymph Node Metastasis in Oral, Oropharyngeal and Hypopharyngeal Cancer: A Comparative Subsite Analysis

Sensitivity and Specificity of Extranodal Extension: Unlocking One of the Strongest Prognostic Factors in Head and Neck Cancer

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