{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:23:05Z","timestamp":1786123385707,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"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;amp; Neck"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Head and Neck Cancer International Group (HNCIG) recently proposed standardized classifications for imaging\u2010detected extranodal extension (iENE) and pathological ENE (pENE). We evaluated the prognostic value of iENE in pENE\u2010positive head and neck squamous cell carcinoma (HNSCC) treated with postoperative chemoradiotherapy (CRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with pENE\u2010positive HNSCC who underwent postoperative CRT were retrospectively analyzed. iENE and pENE were re\u2010classified using HNCIG criteria. Recurrence\u2010free survival (RFS) and overall survival (OS) were analyzed using Kaplan\u2013Meier and Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ninety\u2010two patients were included. iENE grades 2\u20133 were associated with significantly worse outcomes than grades 0\u20131 (3\u2010year RFS: 68.5% vs. 31.5%, log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0002; 3\u2010year OS: 85.0% vs. 63.2%, log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). In multivariable analysis, iENE was the only independent prognostic factor for RFS and OS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative iENE is a prognostic factor in pENE\u2010positive HNSCC after postoperative CRT, with grades 2\u20133 identifying a very high\u2010risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70256","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T02:31:09Z","timestamp":1775269869000},"page":"2394-2403","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Significance of Preoperative Imaging\u2010Detected Extranodal Extension in Pathological Extranodal Extension\u2010Positive Head and Neck Squamous Cell Carcinoma Treated With Postoperative Chemoradiotherapy"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-5652-6665","authenticated-orcid":false,"given":"Yuta","family":"Hoshi","sequence":"first","affiliation":[{"name":"Department of Head and Neck Medical Oncology National Cancer Center Hospital East  Chiba Japan"},{"name":"Department of Head and Neck Surgery Institute of Science Tokyo Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4337-2782","authenticated-orcid":false,"given":"Hirofumi","family":"Kuno","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1133-3313","authenticated-orcid":false,"given":"Shingo","family":"Sakashita","sequence":"additional","affiliation":[{"name":"Division of Pathology, Exploratory Oncology Research and Clinical 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