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Would you treat extranodal extension WITHIN a matted nodal mass differently than at the surface in the postoperative setting for H&N cancer?

In the case of a nodal mass of several nodes matted together due to ENE but without apparent ENE at the surface, does your management change? Is ENE considered a high risk feature because of its potential to have microscopic spread, or does the mere presence of ENE denote aggressive biology and warrant more intense treatment?
1 Answer
Mednet Member
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Radiation Oncology · University of Michigan
Answered on

A matted nodes is a poor prognostic factor for both regional and metastatic disease. Our data https://www.ncbi.nlm.nih.gov/pubmed/25914344 shows a high risk of metastatic disease in HPV+ OPC, suggesting a need to intensify systemic therapy. This is supported by additional published data.

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