Extra-nodal extension in head and neck cancer: how radiologists can help staging and treatment planning.
Jpn J Radiol
; 38(6): 489-506, 2020 Jun.
Article
em En
| MEDLINE
| ID: mdl-32096063
ABSTRACT
Extranodal extension (ENE) is a significant prognostic factor in p16-negative head and neck squamous-cell carcinoma and is classified as N3b by the American Joint Committee on Cancer 8th edition. While most previous radiological studies have focused on the diagnostic performance of pathological ENE, radiologists should be able to provide more clinically relevant information on this entity. The purpose of this article is to review the clinical implications of ENE, to describe key imaging features of ENE with clinical and histopathological correlations and to discuss evaluation of ENE for clinical staging, treatment planning, and predicting the response to treatment. First, we discuss the basics of ENE, including definitions of pathological and clinical ENE and its association with imaging findings. Second, we describe the ENE extension pattern at each location according to level system. The crucial structures determining the choice of treatment include the deep fascia in the deep cervical layer, internal and common carotid arteries, and mediastinal structures. Invasion of the muscles, internal jugular vein, nerves, or mandible also affect the surgical procedure. Finally, we discuss assessment of nodal metastasis after chemoradiotherapy.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Imageamento por Ressonância Magnética
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Tomografia Computadorizada por Raios X
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Carcinoma de Células Escamosas de Cabeça e Pescoço
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Neoplasias de Cabeça e Pescoço
Tipo de estudo:
Prognostic_studies
Limite:
Female
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Humans
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Male
Idioma:
En
Revista:
Jpn J Radiol
Ano de publicação:
2020
Tipo de documento:
Article