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

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.