Liao Yu-Hao, Chen Ya-Fang, Hsieh Min-Shu, Lin Mei-Chun, Wang Chun-Wei, Wang Cheng-Ping, Lou Pei-Jen, Chen Tseng-Cheng
Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Head Neck. 2025 Feb;47(2):667-678. doi: 10.1002/hed.27978. Epub 2024 Nov 4.
Extranodal extension (ENE) had been included in the latest cancer staging system in hypopharyngeal squamous cell carcinoma (HypoSCC). However, the impact of ENE on HypoSCC survival and treatment outcomes are still unclear.
Records from all HypoSCC patients diagnosed at the National Taiwan University Hospital from January 2007 to December 2018 were reviewed. All patients were divided into two groups, with or without ENE. Clinical features, pathological factors, and survival rates between the two groups were reviewed.
We analyzed data from 388 HypoSCC patients, 125 (32.22%) with and 263 (67.78%) without ENE. The 5-year overall survival of the HypoSCC patients with radiological ENE, pathological ENE, and without ENE were 22.9%, 40.3%, and 55.5%. From the multivariate analysis, primary T3/T4 classification (p = 0.001) and radiological ENE (p < 0.001) were independent risk factors for disease-free and overall survival (OS). Finally, upfront neck dissection may significantly benefit disease-free survival (DFS) and neck nodal control in ENE+ (p = 0.002 and p = 0.007, respectively) or ENE- patients (p = 0.003 and p = 0.02, respectively).
More than one-third of HypoSCC patients have ENE, with significantly lower OS and DFS. The upfront neck dissection could provide better DFS and neck nodal control.
下咽鳞状细胞癌（HypoSCC）的最新癌症分期系统纳入了淋巴结外侵犯（ENE）。然而，ENE对HypoSCC生存及治疗结果的影响仍不明确。
回顾了2007年1月至2018年12月在台湾大学医院确诊的所有HypoSCC患者的记录。所有患者分为两组，有或无ENE。比较两组的临床特征、病理因素及生存率。
我们分析了388例HypoSCC患者的数据，其中125例（32.22%）有ENE，263例（67.78%）无ENE。有影像学ENE、病理ENE及无ENE的HypoSCC患者的5年总生存率分别为22.9%、40.3%和55.5%。多因素分析显示，原发灶T3/T4分级（p = 0.001）和影像学ENE（p < 0.001）是无病生存和总生存（OS）的独立危险因素。最后，对于有ENE+（分别为p = 0.002和p = 0.007）或无ENE（分别为p = 0.003和p = 0.02）的患者， upfront颈部清扫术可能显著改善无病生存（DFS）和颈部淋巴结控制。
超过三分之一的HypoSCC患者有ENE，其OS和DFS显著较低。 upfront颈部清扫术可提供更好的DFS和颈部淋巴结控制。
