Radiological detection of extracapsular spread in head and neck squamous cell carcinoma (HNSCC) cervical metastases

Url, Christoph; Schartinger, Volker Hans; Riechelmann, Herbert; Glückert, Rudolf; Maier, Hans; Trumpp, M.; Widmann, Gerlig

doi:10.1016/j.ejrad.2013.04.024

Cited by 48 publications

(41 citation statements)

References 18 publications

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“…Justification for the first‐line use of TORS over CRT in these instances is therefore limited, unless future randomized trials demonstrate a survival advantage. Predicting ECE based on physical examination and imaging is often not straightforward; however, there is an association between increasing nodal involvement and risk of ECE . This is of special significance when considering TORS for HPV‐driven tumors, where a small primary is often accompanied by disproportionally advanced nodal disease, which often demonstrates ECE .…”

Section: Discussionmentioning

confidence: 99%

Decision management in transoral robotic surgery: Indications, individual patient selection, and role in the multidisciplinary treatment for head and neck cancer from a European perspective

2015

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Section: Discussionmentioning

confidence: 99%

Decision management in transoral robotic surgery: Indications, individual patient selection, and role in the multidisciplinary treatment for head and neck cancer from a European perspective

2015

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“…Radiologic predictors of ENE in HNSCC have been a topic of continued investigation. In aggregate, the literature ranges from 65% to 90% for sensitivity, 73% to 91% for specificity, and 75% to 86% for accuracy in predicting pathologic ENE using contrast‐enhanced computed tomography (cCT) . These studies were performed using HNSCC from heterogenous or undefined anatomic subsites and did not account for the role of HPV status.…”

Section: Introductionmentioning

confidence: 99%

“…Geltzeiler et al found the presence of three or more radiologically suspicious lymph nodes to be strongly associated with ENE (positive predictive value [PPV] = 91%), whereas Patel et al found the interruption of the capsule and invasion into the perinodal fat to be poorly predictive of ENE (PPV = 44–55%). Nevertheless, whereas many of these studies defined imaging criteria to identify radiologic ENE, the performance characteristics for specific ENE‐associated imaging features remain largely undefined in a systematic manner. In the present study, we investigate the performance characteristics of imaging features that may be associated with pathologic ENE in a cohort of patients with surgically treated HPV‐OPC.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography performance in predicting extranodal extension in HPV‐positive oropharynx cancer

et al. 2019

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Objectives: To evaluate the performance characteristics of seven predetermined imaging features on pretreatment computed tomography (CT) in identifying extranodal extension (ENE) in cervical lymph node metastases from human papillomavirus-positive oropharyngeal carcinoma (HPV-OPC).Study Design: Retrospective study. Methods: Seventy-three patients with HPV-OPC who underwent primary surgery and cervical lymph node dissection were included. Preoperative contrast-enhanced CT (cCT) imaging was evaluated by two radiologists blinded to pathological results. Each cCT was scored for seven imaging features of interest: 1) indistinct capsular contours, 2) irregular nodal margins, 3) perinodal fat stranding, 4) perinodal fat planes, 5) nodal necrosis, 6) intranodal cysts, and 7) nodal matting. Logistic regression was employed to determine radiologist-specific odds ratios (OR) of predicting ENE for each imaging feature and radiologistspecific receiver operating characteristics (sensitivity [Sn], specificity [Sp], area under the curve [AUC], positive predictive value [PPV], negative predictive value [NPV]) for each imaging feature.Results: Thirty-two (44%) patients had ENE-positive lymph nodes. The presence of irregular margins (OR A = 12.3, 95% confidence interval [CI] A = 2.3-65.9; OR B = 7.0, 95% CI B = 1.4-36.3) and absence of perinodal fat plane (OR A = 6.8, 95% CI A = 2.0-23.3; OR B = 14.2, 95% CI B = 1.7-120.5) were significantly associated with ENE for each radiologist. Irregular nodal margin status was most specific for ENE (Sn A = 45%, Sp A = 94%, AUC A = 69%, PPV A = 82%, NPV A = 73%; Sn B = 28%, Sp B = 95%, AUC B = 61%, PPV B = 80%, NPV B = 64%). Absence of perinodal fat plane was most sensitive for ENE (Sn A = 87%, Sp A = 50%, AUC A = 69%, PPV A = 59%, NPV A = 62%; Sn B = 96%, Sp B = 34%, AUC B = 65%, PPV B = 53%, NPV B = 63%).Conclusions: Of the seven imaging features hypothesized to be associated with ENE-status, the presence of irregular nodal margins and absence of perinodal fat plane were the most specific and sensitive features, respectively.

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“…Owing to the highly invasive nature of HNSCC, it is often associated with locoregional recurrence and metastasis to cervical lymph nodes. 2–5 Early-stage tumors are often treated with radiation or surgery, while later-stage tumors are treated with the combination of surgery, radiotherapy, and/or chemotherapy. 6 Despite attempts to develop new and improved treatment strategies, the 5-year survival rate associated with HNSCC has not significantly changed and still remains approximately 40% to 50%.…”

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confidence: 99%

MicroRNA-375 Suppresses Extracellular Matrix Degradation and Invadopodial Activity in Head and Neck Squamous Cell Carcinoma

Jimenez

Sharma²,

Condeelis³

et al. 2015

Archives of Pathology &Amp; Laboratory Medicine

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Context Head and neck squamous cell carcinoma (HNSCC) is a highly invasive cancer with an association with locoregional recurrence and lymph node metastasis. We have previously reported that low microRNA-375 (miR-375) expression levels correlate with poor patient survival, increased locoregional recurrence, and distant metastasis. Increasing miR-375 expression in HNSCC cell lines to levels found in normal cells results in suppressed invasive properties. HNSCC invasion is mediated in part by invadopodia-associated degradation of the extracellular matrix. Objective To determine whether elevated miR-375 expression in HNSCC cell lines also affects invadopodia formation and activity. Design For evaluation of the matrix degradation properties of the HNSCC lines, an invadopodial matrix degradation assay was used. The total protein levels of invadopodia-associated proteins were measured by Western blot analyses. Immunoprecipitation experiments were conducted to evaluate the tyrosine phosphorylation state of cortactin. Human Protease Arrays were used for the detection of the secreted proteases. Quantitative real time–polymerase chain reaction measurements were used to evaluate the messenger RNA (mRNA) expression of the commonly regulated proteases. Results Increased miR-375 expression in HNSCC cells suppresses extracellular matrix degradation and reduces the number of mature invadopodia. Higher miR-375 expression does not reduce cellular levels of selected invadopodia-associated proteins, nor is tyrosine phosphorylation of cortactin altered. However, HNSCC cells with higher miR-375 expression had significant reductions in the mRNA expression levels and secreted levels of specific proteases. Conclusions MicroRNA-375 regulates invadopodia maturation and function potentially by suppressing the expression and secretion of proteases.

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Radiological detection of extracapsular spread in head and neck squamous cell carcinoma (HNSCC) cervical metastases

Cited by 48 publications

References 18 publications

Decision management in transoral robotic surgery: Indications, individual patient selection, and role in the multidisciplinary treatment for head and neck cancer from a European perspective

Decision management in transoral robotic surgery: Indications, individual patient selection, and role in the multidisciplinary treatment for head and neck cancer from a European perspective

Computed tomography performance in predicting extranodal extension in HPV‐positive oropharynx cancer

MicroRNA-375 Suppresses Extracellular Matrix Degradation and Invadopodial Activity in Head and Neck Squamous Cell Carcinoma

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