title: Cervical node metastases in squamous cell carcinoma of the upper aerodigestive tract: the significance of extracapsular spread and soft tissue deposits.
abstract: BACKGROUND
  Literature regarding the prognostic significance of extracapsular spread and soft tissue deposits in cervical lymph node metastases of squamous cell carcinoma of the upper aerodigestive tract shows variable results.
  
  
  METHODS
  We analyzed 215 prospectively collected neck dissections from 155 patients with upper aerodigestive tract squamous cell carcinoma to assess the prevalence of extracapsular spread and soft tissue deposits and to assess their effect on survival.
  
  
  RESULTS
  Both extracapsular spread and soft tissue deposits significantly reduced survival (actuarial and recurrence free) compared with pN0 necks (p <.001) and pN+ve necks without extracapsular spread (p <.0025). There was no statistically significant difference between pN+ve necks without soft tissue deposits or extracapsular spread compared with those with pN0 necks (p =.24). Multivariate analysis revealed comparable results.
  
  
  CONCLUSIONS
  Microscopic and macroscopic extracapsular spread and soft tissue deposits are of prognostic significance for survival and recurrence-free survival in patients with upper aerodigestive tract squamous cell carcinoma.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Leeds General Infirmary, Great George Street, Leeds, United Kingdom.
authors.forename: Jemy
authors.initials: J
authors.lastname: Jose
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Coatesworth
authors.forename: Colin
authors.initials: C
authors.lastname: Johnston
authors.forename: Ken
authors.initials: K
authors.lastname: MacLennan
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D037981:Neck Dissection; D010610:Pharyngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012983:Soft Tissue Neoplasms / Q000556:secondary*; D016019:Survival Analysis