{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:32:39Z","timestamp":1761006759138,"version":"build-2065373602"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The primary objective was to investigate the effect of extra\u2010nodal extension (ENE) grading on the survival of pN\u2010positive patients with laryngeal squamous cell carcinoma (LSCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A tertiary referral center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The patients with LSCC were retrospectively reviewed. The histopathological slides of patients were re\u2010examined, and ENE was graded. Survival analyses were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010six patients were enrolled in this study. The average age of patients was 61.29 years. 3\u2010year overall survival (OS), disease\u2010specific survival (DSS), and disease\u2010free survival (DFS) rates were 69.7%, 73.7%, and 73.7%, respectively. ENE grading had no statistically significant impact on survival rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While the presence of ENE in more than 4 lymph nodes, lymph node density (LND) greater than 0.2, poor histologic differentiation, and not receiving chemotherapy were identified as independent poor prognosticators in LSCC, the study did not show any effect of ENE grading on survival rates.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.1297","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T02:25:38Z","timestamp":1746498338000},"page":"660-670","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Importance of Extranodal Extension Grading in Laryngeal Squamous Cell 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