ENT Clinic, Head and Neck Department, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy.
Department of Histopathology, Cattinara Hospital of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy.
Br J Oral Maxillofac Surg. 2021 Jun;59(5):567-572. doi: 10.1016/j.bjoms.2020.09.015. Epub 2020 Sep 12.
To investigate the prognostic significance of the stratification of extranodal extension (ENE) into ENE minor (ENEmi, up to 2mm) and ENE major (ENEma, over 2mm) in non-HPV-related squamous cell cancers of the head and neck, we retrospectively reviewed microscopic slides from neck dissection specimens of ENE-positive patients and subcategorised them into ENEmi and ENEma. We then compared the two groups in terms of overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). Forty-four patients with pathologically positive necks had ENE in the histological report. Twenty-six had ENEmi and 18 ENEma. The three-year OS was 46% in the ENEmi group and 38.9% in the ENEma group. DSS and DFS were 80.8% and 80.8%, respectively, in the ENEmi group and 61.1% and 77.8%, respectively, in the ENEma group. None of the comparisons revealed any statistically significant difference. The results of our survival analysis seem to show a trend towards better survival rates in the ENEmi group, particularly regarding OS. Nonetheless, extension of the tumour outside the lymph node capsule by more than 2mm was not found to be significantly associated with any of the explored survival outcomes.
为了探究在非 HPV 相关头颈部鳞癌中，将淋巴结外侵犯（ENE）细分为ENE 微小侵犯（ENEmi，最多 2mm）和 ENE 广泛侵犯（ENEma，超过 2mm）的分层对预后的意义，我们回顾性地分析了颈部淋巴结清扫术标本的显微镜切片，根据是否存在 ENE 将病例分为 ENEmi 和 ENEma 两组。然后比较了两组的总生存（OS）、疾病特异性生存（DSS）和无病生存（DFS）。在病理报告中，44 例患者的颈部存在 ENE。其中 26 例为 ENEmi，18 例为 ENEma。ENEmi 组的 3 年 OS 为 46%，ENEma 组为 38.9%。ENEm 组的 DSS 和 DFS 分别为 80.8%和 80.8%，ENEma 组分别为 61.1%和 77.8%。这些比较均无统计学差异。我们的生存分析结果似乎表明，ENEmi 组的生存率有升高的趋势，特别是 OS。然而，肿瘤侵犯淋巴结包膜超过 2mm 与任何探索的生存结局均无显著相关性。
