Extracapsular spread in head and neck squamous cell carcinoma: A systematic review and meta-analysis. (November 2016)

• Record Type: Journal Article
• Authors: Mermod, Maxime; Tolstonog, Genrich; Simon, Christian; Monnier, Yan
• Is Part Of: Oral oncology. Volume 62(2016:Nov.)
• Page Start: 60
• Page End: 71
• Publication Date: 2016-11
• Subjects: Extracapsular spread -- Extranodal spread -- Perinodal spread -- Transcapsular spread -- Lymph node metastasis -- Head and neck squamous cell carcinoma -- Systematic review -- Meta-analysis -- HPV; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2016.10.003
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: ECS is a major prognostic factor in HNSCC. No standardized histological diagnostic and grading criteria are available for ECS. There is a correlation between the level of extension of ECS and a poor prognosis. Cisplatin-based chemo-radiotherapy is the recommended treatment for ECS. ECS is not an adverse prognostic factor in HPV-positive OPSCC. Abstract: 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of the review, meta-analyses were performed on relevant aspects of ECS for which previous quantitative data were outdated or not available.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.