{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T11:24:53Z","timestamp":1783164293041,"version":"3.54.6"},"reference-count":19,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The purpose of this study is to assess inter\u2010rater agreement in both diagnosis and extent of ENE in head and neck squamous cell carcinoma among head and neck pathologists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Representative slides from 50 random patients exhibiting various extents of ENE obtained from patients who had undergone neck dissection were selected and reviewed by eight head and neck pathologists across four tertiary referral head and neck institutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Inter\u2010rater agreement for the presence of ENE was moderate (kappa\u2009=\u20090.33). For minor ENE, the inter\u2010rater agreement was slight (kappa\u2009=\u20090.03) and for the presence of major ENE the inter\u2010rater agreement was also slight (kappa\u2009=\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings of only slight to fair consistency in the histopathological diagnosis and characterization of ENE across multiple high volume tertiary Head and Neck centers suggest the imperative need for a consensus guideline among pathologists in both processing of lymph nodes and interpretation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70199","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:08:45Z","timestamp":1773011325000},"page":"2099-2106","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Inter\u2010Rater Agreement in the Interpretation of Extranodal Extension of Metastatic Squamous Cell Carcinoma\u2014A Multi\u2010Institutional Study"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3791-4925","authenticated-orcid":false,"given":"Leba M.","family":"Sarkis","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery Chris O'brien Lifehouse  Sydney New South Wales Australia"},{"name":"Sydney Medical School University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Royal North Shore Hospital, St. Leonards  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0464-5087","authenticated-orcid":false,"given":"Stephen M.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathobiology University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susie","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Princess Margaret Cancer Center  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery, Princess Margaret Cancer Centre\/University Health Network University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department Pathology Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Katabi","sequence":"additional","affiliation":[{"name":"Department Pathology Memorial Sloan Kettering Cancer Center  New York New York 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