title: Radiographic extracapsular extension and treatment outcomes in locally advanced oropharyngeal carcinoma.
abstract: BACKGROUND
  Pathologic extracapsular extension (pECE) in metastatic lymph nodes is associated with poor prognosis for oropharyngeal carcinoma. The prognostic value of radiographic extracapsular extension (rECE) has not been studied.
  
  
  METHODS
  A retrospective analysis was conducted of 111 patients with locally advanced oropharyngeal carcinoma treated in the Mount Sinai Radiation Oncology Department with accessible pretreatment CT reports. Univariate Kaplan-Meier and multivariate Cox regression analyses compared cohorts for locoregional control, distant control, progression-free (PFS), and overall survival (OS).
  
  
  RESULTS
  Sixty-four patients had rECE-present and 47 had rECE-absent scans. The patients with rECE presence had significantly worse OS (3-year: 95% vs 77%; p = .006), PFS (3-year: 91% vs 71%; p = .002), and distant control (3-year: 98% vs 81%; p = .008), with no difference in locoregional control. On multivariate analysis, rECE-presence was a negative prognosticator for OS, PFS, and distant control.
  
  
  CONCLUSIONS
  This study suggests that rECE is an independent prognosticator of poor distant control and survival with little impact on locoregional control for oropharyngeal carcinoma.
authors.affiliation: Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Benjamin H
authors.initials: BH
authors.lastname: Kann
authors.forename: Michael
authors.initials: M
authors.lastname: Buckstein
authors.forename: Todd J
authors.initials: TJ
authors.lastname: Carpenter
authors.forename: Richard
authors.initials: R
authors.lastname: Bakst
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Misiukiewicz
authors.forename: Eric
authors.initials: E
authors.lastname: Genden
authors.forename: Marshall
authors.initials: M
authors.lastname: Posner
authors.forename: Lale
authors.initials: L
authors.lastname: Kostakoglu
authors.forename: Peter
authors.initials: P
authors.lastname: Som
authors.forename: Vishal
authors.initials: V
authors.lastname: Gupta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: extracapsular extension; neoplasm metastasis; oropharyngeal neoplasms; radiology; squamous cell carcinoma