In this multicenter cohort study of 92 patients with oropharyngeal squamous cell carcinoma (OPSCC), McMullen et al evaluate the rate of occult extranodal extension (ENE) and postoperative nodal upstaging among patients with localized OPSCC treated by transoral robotic surgery with neck dissection. The authors found that 26% of patients had a postoperative change in nodal category, although only 13% had unanticipated ENE. The study’s results suggest that radiographically positive nodes and a more advanced nodal category may be associated with ENE, whereas the T category, size of the largest node, and tumor location may not.
Highlights. JAMA Otolaryngol Head Neck Surg. 2019;145(8):697. doi:10.1001/jamaoto.2018.2793
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