Extranodal extension (ENE) is a significant prognostic factor for human papillomavirus (HPV)-negative head and neck squamous cell carcinoma. However, it remains controversial whether ENE is prognostically relevant in HPV-positive oropharyngeal squamous cell carcinoma (OPSCC). The host discusses with Dr. Nora Katabi from Memorial Sloan Kettering Cancer Center her team’s recent study on the topic.

Patients with ENE had shortened overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). The 5-year OS, DSS, and DFS were 95%, 97%, and 90% for the group without ENE, and 64%, 71%, and 65% respectively for the group with ENE. On multivariate survival analysis, the presence of ENE was an independent adverse prognostic factor for OS, DSS, and DFS. The authors propose to document the presence and extent of ENE for these tumors and give consideration for the American Joint Committee on Cancer (AJCC) 9th edition to include ENE into pN stage of HPV-positive OPSCC.