Extranodal extension (ENE) refers to the spread of head and neck squamous cell carcinoma (HNSCC) outside the lymph nodes. It is a well-known factor that indicates a poorer prognosis and outcome for patients who have undergone surgical removal of the cancer. In such cases, it is recommended to combine chemotherapy with radiation therapy after surgery. As the number of cases of HNSCC related to the human papillomavirus (HPV) is increasing, treatment approaches have shifted towards using radiation therapy as the primary treatment method instead of surgery. This raises an important question about the significance of ENE observed through imaging tests (referred to as iENE) and its impact on the prognosis. Unfortunately, this question remains unanswered. The objective of this project is to conduct a comprehensive study across multiple medical institutions. The investigators will gather data including scan results, histopathology reports, and data from patient charts from individuals who have been treated for head and neck cancer. The aim is to analyze and correlate the findings between the pathological evidence of ENE and the imaging results, while also assessing the prognostic value of iENE. Additionally, the investigators will explore the influence of HPV status on these factors. By collecting and analyzing this data, the investigators hope to establish standardized criteria that can assist radiologists in accurately identifying ENE through imaging tests. This research is essential for enhancing our understanding of HNSCC and improving the effectiveness of diagnostic procedures and treatment planning.
Study Type
OBSERVATIONAL
Enrollment
3,500
Extranodal extension presence or absence on radiology and pathology assessment
Methodist Estabrook Cancer Center
Omaha, Nebraska, United States
Mount Sinai Health System
New York, New York, United States
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States
Royal Adelaide Hospital
Adelaide, Australia
Copenhagen University Hospitals
Copenhagen, Denmark
Georges Pompidou European Hospital
Paris, France
University of Cologne
Cologne, Germany
Technical University of Munich
Munich, Germany
Catalan Institute of Oncology
Barcelona, Spain
University Hospital Zürich
Zurich, Switzerland
...and 2 more locations
To assess the accuracy of the identification of iENE by radiologists in real world situations by correlating with histopathology (pENE)
Endpoints: Accuracy of a radiologic "call" of iENE (with pENE being the gold standard comparator) by radiologists not trained for any standardized diagnostic classification systems for iENE.
Time frame: 31 December 2023
To evaluate the prognostic significance (overall survival rates) of iENE.
Endpoints: Overall survival rates based on presence of iENE and pENE
Time frame: 31 December 2023
To evaluate the prognostic significance (recurrence rates) of iENE
Endpoints: Recurrence rates based on presence of iENE and pENE
Time frame: 31 December 2023
To evaluate the prognostic significance (overall survival rates) of iENE: Risk stratify HNSCC patients based on presence of radiographic ENE, according to their HPV status and N stage
Endpoints: Overall survival rates based on presence of various degrees of iENE and pENE
Time frame: 31 December 2023
To evaluate the prognostic significance (recurrence rates) of iENE: Risk stratify HNSCC patients based on presence of radiographic ENE, according to their HPV status and N stage
Endpoints: Recurrence rates based on presence of various degrees of iENE and pENE
Time frame: 31 December 2023
Improve the diagnosis of iENE: Determine radiological features of iENE that best correlate with pENE (the gold standard comparator)
Endpoints: Diagnostic accuracy of various radiographic features of iENE with pENE.
Time frame: 31 December 2023
Assess the utility of various existing standardized diagnostic classification systems in accurately diagnosing iENE
Endpoints: Diagnostic accuracy of published standardized classification systems with pENE
Time frame: 31 December 2023
Measure interobserver variability amongst radiologists in grading radiographic ENE and to measure impact of standardized criteria on this variability
Endpoints: Interobserver variability measured by Cohen's kappa
Time frame: 31 December 2023
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