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Invited Commentary
July 2018

Characterizing an Ultra–High-Risk Subset of Patients With Hypopharynx and Larynx Cancer: The Power of Lymph Node Burden

Author Affiliations
  • 1Division of Otolaryngology–Head & Neck Surgery, Department of Surgery, University of California, San Diego, Moores Cancer Center, La Jolla
  • 2Division of Hematology-Oncology, Department of Internal Medicine, University of California, San Diego, Moores Cancer Center, La Jolla
JAMA Oncol. 2018;4(7):989-990. doi:10.1001/jamaoncol.2017.3928

Staging systems for squamous cell carcinoma of the head and neck (SCCHN) vary by anatomic subsite. Nodal classifications across subsites are similar and are based on the size, number, and laterality of positive regional lymph nodes (LNs). In clinical practice, it is commonly held that contralateral nodal metastases are a poor prognosticator, and the same logic is generally applied to cases with large positive nodes. The American Joint Committee on Cancer’s AJCC Staging Manual, 8th edition, to be implemented in 2018, continues using the traditional nodal characteristics and adds extranodal extension as an important feature.

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