• The lancet oncology · Jul 2024

    Review

    Criteria for the diagnosis of extranodal extension detected on radiological imaging in head and neck cancer: Head and Neck Cancer International Group consensus recommendations.

    • Christina Henson, Ahmad K Abou-Foul, Eugene Yu, Christine Glastonbury, Shao Hui Huang, Ann D King, William M Lydiatt, Lachlan McDowell, Alex A Nagelschneider, Paul C Nankivell, Brian O'Sullivan, Rhian Rhys, Youping Xiao, David Andrew, Jon T Asmussen, Francois Bidault, Jan W Dankbaar, Pim de Graaf, Eloisa S Gebrim, Chaosu Hu, Jianhui Ding, Tomonori Kanda, Jane Kim, Hirofumi Kuno, Santiago Medrano-Martorell, Nikolaos Oikonomopoulos, Julian Park-Nam Goh, Eloisa Santos-Armentia, Darius G Schafigh, Rathan M Subramaniam, Xin Cynthia Wu, Sue S Yom, and Hisham Mehanna.
    • Department of Radiation Oncology, Stephenson Cancer Center, University of Oklahoma Health Sciences Centre, Oklahoma City, OK, USA.
    • Lancet Oncol. 2024 Jul 1; 25 (7): e297e307e297-e307.

    AbstractExtranodal extension of tumour on histopathology is known to be a negative prognostic factor in head and neck cancer. Compelling evidence suggests that extranodal extension detected on radiological imaging is also a negative prognostic factor. Furthermore, if imaging detected extranodal extension could be identified reliably before the start of treatment, it could be used to guide treatment selection, as patients might be better managed with non-surgical approaches to avoid the toxicity and cost of trimodality therapy (surgery, chemotherapy, and radiotherapy together). There are many aspects of imaging detected extranodal extension that remain unresolved or are without consensus, such as the criteria to best diagnose them and the associated terminology. The Head and Neck Cancer International Group conducted a five-round modified Delphi process with a group of 18 international radiology experts, representing 14 national clinical research groups. We generated consensus recommendations on the terminology and diagnostic criteria for imaging detected extranodal extension to harmonise clinical practice and research. These recommendations have been endorsed by 19 national and international organisations, representing 34 countries. We propose a new classification system to aid diagnosis, which was supported by most of the participating experts over existing systems, and which will require validation in the future. Additionally, we have created an online educational resource for grading imaging detected extranodal extensions.Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.

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