期刊
ORAL ONCOLOGY
卷 62, 期 -, 页码 60-71出版社
ELSEVIER
DOI: 10.1016/j.oraloncology.2016.10.003
关键词
Extracapsular spread; Extranodal spread; Perinodal spread; Transcapsular spread; Lymph node metastasis; Head and neck squamous cell carcinoma; Systematic review; Meta-analysis; HPV
资金
- Swiss Commission for Technology and Innovation (CTI) [16014.1 PFLS-LS]
Extracapsular spread (ECS) is one of the most important prognostic factors in head and neck squamous cell carcinoma (HNSCC). However, despite its major clinical relevance, there are still a number of important remaining issues regarding this condition. Indeed, standardized diagnostic and grading criteria of ECS are still lacking. The imaging modality of choice for its diagnosis is a matter of debate. Current research looking at the identification of specific biomarkers is ongoing. Recent findings demonstrate a direct correlation between the level of extension of ECS and a poor prognosis. Accumulating data show that ECS does not carry the same adverse features in human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC). New treatment strategies based on these factors are currently considered to investigate the possibility of diminishing the toxicity of chemo-radiotherapy while maintaining similar outcomes. The goal of this article was to provide a systematic review of the literature covering all the issues related to ECS. As an additional component of the review, meta-analyses were performed on relevant aspects of ECS for which previous quantitative data were outdated or not available. The results of these meta-analyses confirm the negative impact of ECS on loco-regional recurrence and distant metastasis. They also demonstrate the absence of a negative impact of ECS in HPV-positive OPSCC. (C) 2016 Elsevier Ltd. All rights reserved.
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