{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T22:00:07Z","timestamp":1791669607270,"version":"4.3.4"},"reference-count":80,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T00:00:00Z","timestamp":1599868800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T00:00:00Z","timestamp":1599868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"funder":[{"DOI":"10.13039\/501100004196","name":"Odense Universitetshospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004196","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006356","name":"Syddansk Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006356","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008262","name":"Harboefonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008262","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Region of Southern Denmark"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Head and Neck Pathol"],"published-print":{"date-parts":[[2021,6]]},"DOI":"10.1007\/s12105-020-01221-4","type":"journal-article","created":{"date-parts":[[2020,9,12]],"date-time":"2020-09-12T05:02:25Z","timestamp":1599886945000},"page":"599-607","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Histopathological Definitions of Extranodal Extension: A Systematic Review"],"prefix":"10.1007","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3029-6204","authenticated-orcid":false,"given":"Chadi Nimeh","family":"Abdel-Halim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tine","family":"Rosenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stine Rosenkilde","family":"Larsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poul Flemming","family":"H\u00f8ilund-Carlsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens Ahm","family":"S\u00f8rensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Rohde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Godballe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,12]]},"reference":[{"issue":"4","key":"1221_CR1","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/0002-9610(85)90162-X","volume":"150","author":"RL Carter","year":"1985","unstructured":"Carter RL, et al. Transcapsular spread of metastatic squamous cell carcinoma from cervical lymph nodes. Am J Surg. 1985;150(4):495\u20139.","journal-title":"Am J Surg"},{"issue":"6","key":"1221_CR2","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1002\/hed.10214","volume":"25","author":"J Jose","year":"2003","unstructured":"Jose J, et al. Cervical node metastases in squamous cell carcinoma of the upper aerodigestive tract: the significance of extracapsular spread and soft tissue deposits. Head Neck. 2003;25(6):451\u20136.","journal-title":"Head Neck"},{"issue":"3","key":"1221_CR3","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1002\/path.1700330302","volume":"33","author":"RA Willis","year":"1930","unstructured":"Willis RA. Epidermoid carcinoma of the head and neck, with special reference to metastasis. J Pathol Bacteriol. 1930;33(3):501\u201326.","journal-title":"J Pathol Bacteriol"},{"issue":"5","key":"1221_CR4","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1002\/1097-0142(1971)28:5<1255::AID-CNCR2820280524>3.0.CO;2-A","volume":"28","author":"SH Bennett","year":"1971","unstructured":"Bennett SH, et al. Prognostic significance of histologic host response in cancer of the larynx or hypopharynx. Cancer. 1971;28(5):1255\u201365.","journal-title":"Cancer"},{"issue":"4","key":"1221_CR5","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1288\/00005537-198004000-00001","volume":"90","author":"DE Schuller","year":"1980","unstructured":"Schuller DE, et al. The prognostic significance of metastatic cervical lymph nodes. Laryngoscope. 1980;90(4):557\u201370.","journal-title":"Laryngoscope"},{"issue":"2","key":"1221_CR6","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1002\/hed.2890080202","volume":"8","author":"C Grandi","year":"1985","unstructured":"Grandi C, et al. Prognostic significance of lymphatic spread in head and neck carcinomas: therapeutic implications. Head Neck Surg. 1985;8(2):67\u201373.","journal-title":"Head Neck Surg"},{"issue":"8","key":"1221_CR7","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1016\/S1368-8375(02)00052-0","volume":"38","author":"A Ferlito","year":"2002","unstructured":"Ferlito A, et al. Prognostic significance of microscopic and macroscopic extracapsular spread from metastatic tumor in the cervical lymph nodes. Oral Oncol. 2002;38(8):747\u201351.","journal-title":"Oral Oncol"},{"issue":"12","key":"1221_CR8","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1016\/j.ejca.2006.01.062","volume":"42","author":"AA Dunne","year":"2006","unstructured":"Dunne AA, et al. Meta-analysis of the prognostic significance of perinodal spread in head and neck squamous cell carcinomas (HNSCC) patients. Eur J Cancer. 2006;42(12):1863\u20138.","journal-title":"Eur J Cancer"},{"issue":"10","key":"1221_CR9","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1002\/hed.20279","volume":"27","author":"J Bernier","year":"2005","unstructured":"Bernier J, et al. Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck. 2005;27(10):843\u201350.","journal-title":"Head Neck"},{"issue":"3","key":"1221_CR10","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1111\/j.1365-2273.1982.tb01581.x","volume":"7","author":"GB Snow","year":"1982","unstructured":"Snow GB, et al. Prognostic factors of neck node metastasis. Clin Otolaryngol Allied Sci. 1982;7(3):185\u201392.","journal-title":"Clin Otolaryngol Allied Sci"},{"issue":"6","key":"1221_CR11","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1002\/hed.21244","volume":"32","author":"RJ Shaw","year":"2010","unstructured":"Shaw RJ, et al. Extracapsular spread in oral squamous cell carcinoma. Head Neck. 2010;32(6):714\u201322.","journal-title":"Head Neck"},{"issue":"4","key":"1221_CR12","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1002\/hed.21487","volume":"33","author":"AG Brannan","year":"2011","unstructured":"Brannan AG, Johnstone PA, Cooper J. Extracapsular tumor extension in cervical lymph nodes: reconciling the literature and seer data. Head Neck. 2011;33(4):525\u20138.","journal-title":"Head Neck"},{"issue":"6","key":"1221_CR13","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1002\/hed.21823","volume":"34","author":"MW van den Brekel","year":"2012","unstructured":"van den Brekel MW, et al. Observer variation in the histopathologic assessment of extranodal tumor spread in lymph node metastases in the neck. Head Neck. 2012;34(6):840\u20135.","journal-title":"Head Neck"},{"issue":"11","key":"1221_CR14","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1016\/j.oraloncology.2015.08.003","volume":"51","author":"JS Lewis Jr","year":"2015","unstructured":"Lewis JS Jr, et al. Inter- and intra-observer variability in the classification of extracapsular extension in p16 positive oropharyngeal squamous cell carcinoma nodal metastases. Oral Oncol. 2015;51(11):985\u201390.","journal-title":"Oral Oncol"},{"key":"1221_CR15","first-page":"761","volume-title":"Wiley series in probability and statistics","author":"JL Fleiss","year":"2003","unstructured":"Fleiss JL. Statistical methods for rates and proportions. In: Shewart WA, Wilks SS, editors. Wiley series in probability and statistics. Hoboken: Wiley; 2003. p. 761\u2013768."},{"issue":"9","key":"1221_CR16","doi-asserted-by":"publisher","first-page":"1776","DOI":"10.3174\/ajnr.A4372","volume":"36","author":"AH Aiken","year":"2015","unstructured":"Aiken AH, et al. Accuracy of preoperative imaging in detecting nodal extracapsular spread in oral cavity squamous cell carcinoma. AJNR Am J Neuroradiol. 2015;36(9):1776\u2013811.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"4","key":"1221_CR17","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1016\/j.ijrobp.2018.05.020","volume":"102","author":"A Almulla","year":"2018","unstructured":"Almulla A, et al. Radiologic-pathologic correlation of extranodal extension in patients with squamous cell carcinoma of the oral cavity: implications for future editions of the TNM classification. Int J Radiat Oncol Biol Phys. 2018;102(4):698\u2013708.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"1221_CR18","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1111\/his.13886","volume":"75","author":"K Boeve","year":"2019","unstructured":"Boeve K, et al. Addition of tumour infiltration depth and extranodal extension improves the prognostic value of the pathological TNM classification for early-stage oral squamous cell carcinoma. Histopathology. 2019;75(3):329\u201337.","journal-title":"Histopathology"},{"issue":"3","key":"1221_CR19","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1007\/s12105-019-01014-4","volume":"13","author":"MJ Bullock","year":"2019","unstructured":"Bullock MJ. Current challenges in the staging of oral cancer. Head Neck Pathol. 2019;13(3):440\u20138.","journal-title":"Head Neck Pathol"},{"issue":"4","key":"1221_CR20","doi-asserted-by":"publisher","first-page":"452","DOI":"10.5858\/arpa.2018-0421-SA","volume":"143","author":"MJ Bullock","year":"2019","unstructured":"Bullock MJ, et al. Data set for the reporting of nodal excisions and neck dissection specimens for head and neck tumors: explanations and recommendations of the guidelines from the international collaboration on cancer reporting. Arch Pathol Lab Med. 2019;143(4):452\u201362.","journal-title":"Arch Pathol Lab Med"},{"issue":"3","key":"1221_CR21","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1002\/hed.10020","volume":"24","author":"AP Coatesworth","year":"2002","unstructured":"Coatesworth AP, MacLennan K. Squamous cell carcinoma of the upper aerodigestive tract: the prevalence of microscopic extracapsular spread and soft tissue deposits in the clinically N0 neck. Head Neck. 2002;24(3):258\u201361.","journal-title":"Head Neck"},{"issue":"12","key":"1221_CR22","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1111\/j.1445-2197.1997.tb07613.x","volume":"67","author":"I Cole","year":"1997","unstructured":"Cole I, Hughes L. The relationship of cervical lymph node metastases to primary sites of carcinoma of the upper aerodigestive tract: a pathological study. Aust N Z J Surg. 1997;67(12):860\u20135.","journal-title":"Aust N Z J Surg"},{"issue":"4","key":"1221_CR23","first-page":"18","volume":"69","author":"D Crescenzi","year":"2015","unstructured":"Crescenzi D, et al. TNM classification of the oral cavity carcinomas: some suggested modifications. Otolaryngol Pol. 2015;69(4):18\u201327.","journal-title":"Otolaryngol Pol"},{"issue":"5","key":"1221_CR24","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1001\/jamaoto.2013.2666","volume":"139","author":"J de Juan","year":"2013","unstructured":"de Juan J, et al. Inclusion of extracapsular spread in the pTNM classification system: a proposal for patients with head and neck carcinoma. JAMA Otolaryngol Head Neck Surg. 2013;139(5):483\u20138.","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"10","key":"1221_CR25","doi-asserted-by":"publisher","first-page":"2021","DOI":"10.1002\/hed.24860","volume":"39","author":"KT Fletcher","year":"2017","unstructured":"Fletcher KT, et al. Prognostic indicators and survival in salvage surgery for laryngeal cancer. Head Neck. 2017;39(10):2021\u20136.","journal-title":"Head Neck"},{"key":"1221_CR26","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.oraloncology.2017.05.003","volume":"70","author":"J Garcia","year":"2017","unstructured":"Garcia J, et al. Validation of the pathological classification of lymph node metastasis for head and neck tumors according to the 8th edition of the TNM Classification of Malignant Tumors. Oral Oncol. 2017;70:29\u201333.","journal-title":"Oral Oncol"},{"issue":"5","key":"1221_CR27","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1288\/00005537-199105000-00010","volume":"101","author":"H Hirabayashi","year":"1991","unstructured":"Hirabayashi H, et al. Extracapsular spread of squamous cell carcinoma in neck lymph nodes: prognostic factor of laryngeal cancer. Laryngoscope. 1991;101(5):502\u20136.","journal-title":"Laryngoscope"},{"issue":"4","key":"1221_CR28","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1016\/0360-3016(92)90646-Y","volume":"23","author":"DT Huang","year":"1992","unstructured":"Huang DT, et al. Postoperative radiotherapy in head and neck carcinoma with extracapsular lymph node extension and\/or positive resection margins: a comparative study. Int J Radiat Oncol Biol Phys. 1992;23(4):737\u201342.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"7","key":"1221_CR29","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1002\/hed.21854","volume":"34","author":"SH Huang","year":"2012","unstructured":"Huang SH, et al. Patterns of failure and histopathologic outcome predictors following definitive radiotherapy and planned neck dissection with residual disease. Head Neck. 2012;34(7):913\u201322.","journal-title":"Head Neck"},{"issue":"2","key":"1221_CR30","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1007\/s10396-004-0010-2","volume":"31","author":"J Ishii","year":"2004","unstructured":"Ishii J, et al. Ultrasonography and computed tomography of extracapsular invasion in cervical lymph nodes of squamous cell carcinoma in the oral cavity. J Med Ultrason. 2004;31(2):75\u20139.","journal-title":"J Med Ultrason."},{"issue":"10","key":"1221_CR31","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1055\/s-2007-997028","volume":"77","author":"W Kehrl","year":"1998","unstructured":"Kehrl W, Wenzel S, Niendorf A. Effect of various forms of metastatic lymph node involvement on prognosis of squamous epithelial carcinomas of the upper aerodigestive tract. Laryngorhinootologie. 1998;77(10):569\u201375.","journal-title":"Laryngorhinootologie"},{"issue":"4","key":"1221_CR32","first-page":"943","volume":"20","author":"V Krstevska","year":"2015","unstructured":"Krstevska V. Evolution of treatment and high-risk features in resectable locally advanced head and neck squamous cell carcinoma with special reference to extracapsular extension of nodal disease. J BUON. 2015;20(4):943\u201353.","journal-title":"J BUON"},{"issue":"11","key":"1221_CR33","doi-asserted-by":"publisher","first-page":"1413","DOI":"10.1038\/modpathol.2011.105","volume":"24","author":"JS Lewis Jr","year":"2011","unstructured":"Lewis JS Jr, et al. Extracapsular extension is a poor predictor of disease recurrence in surgically treated oropharyngeal squamous cell carcinoma. Mod Pathol. 2011;24(11):1413\u201320.","journal-title":"Mod Pathol"},{"issue":"6","key":"1221_CR34","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1016\/j.oraloncology.2013.02.010","volume":"49","author":"WL Lodder","year":"2013","unstructured":"Lodder WL, et al. Can extranodal spread in head and neck cancer be detected on MR imaging. Oral Oncol. 2013;49(6):626\u201333.","journal-title":"Oral Oncol"},{"issue":"3","key":"1221_CR35","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1016\/j.otorri.2017.07.002","volume":"69","author":"J Lop","year":"2018","unstructured":"Lop J, et al. Prognostic significance of extranodal extension in head and neck squamous cell carcinoma cN0 patients with occult metastatic neck nodes. Acta Otorrinolaringol Esp. 2018;69(3):156\u201364.","journal-title":"Acta Otorrinolaringol Esp"},{"issue":"2","key":"1221_CR36","doi-asserted-by":"publisher","first-page":"122","DOI":"10.3322\/caac.21389","volume":"67","author":"WM Lydiatt","year":"2017","unstructured":"Lydiatt WM, et al. Head and Neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017;67(2):122\u201337.","journal-title":"CA Cancer J Clin"},{"key":"1221_CR37","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.oraloncology.2017.12.010","volume":"77","author":"K Majercakova","year":"2018","unstructured":"Majercakova K, et al. Postoperative staging of the neck dissection using extracapsular spread and lymph node ratio as prognostic factors in HPV-negative head and neck squamous cell carcinoma patients. Oral Oncol. 2018;77:37\u201342.","journal-title":"Oral Oncol"},{"issue":"7","key":"1221_CR38","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.1002\/lary.25140","volume":"125","author":"JH Maxwell","year":"2015","unstructured":"Maxwell JH, et al. Accuracy of computed tomography to predict extracapsular spread in p16-positive squamous cell carcinoma. Laryngoscope. 2015;125(7):1613\u20138.","journal-title":"Laryngoscope"},{"issue":"1","key":"1221_CR39","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1002\/hed.24537","volume":"39","author":"M Mermod","year":"2017","unstructured":"Mermod M, et al. Correlation between podoplanin expression and extracapsular spread in squamous cell carcinoma of the oral cavity using subjective immunoreactivity scores and semiquantitative image analysis. Head Neck. 2017;39(1):98\u2013108.","journal-title":"Head Neck"},{"key":"1221_CR40","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.oraloncology.2016.10.003","volume":"62","author":"M Mermod","year":"2016","unstructured":"Mermod M, et al. Extracapsular spread in head and neck squamous cell carcinoma: a systematic review and meta-analysis. Oral Oncol. 2016;62:60\u201371.","journal-title":"Oral Oncol"},{"issue":"5","key":"1221_CR41","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1038\/bjc.2011.22","volume":"104","author":"C Michikawa","year":"2011","unstructured":"Michikawa C, et al. Epidermal growth factor receptor gene copy number aberration at the primary tumour is significantly associated with extracapsular spread in oral cancer. Br J Cancer. 2011;104(5):850\u20135.","journal-title":"Br J Cancer"},{"issue":"4","key":"1221_CR42","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1111\/1754-9485.12888","volume":"63","author":"A Noor","year":"2019","unstructured":"Noor A, et al. Predictive value of computed tomography in identifying extracapsular spread of cervical lymph node metastases in p16 positive oropharyngeal squamous cell carcinoma. J Med Imaging Radiat Oncol. 2019;63(4):500\u20139.","journal-title":"J Med Imaging Radiat Oncol"},{"issue":"2","key":"1221_CR43","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1245\/s10434-018-6806-x","volume":"26","author":"YM Park","year":"2019","unstructured":"Park YM, et al. Does p16+ predict a favorable prognosis for oropharyngeal cancer? risk factors for treatment failure for patients who underwent surgery-based therapy. Ann Surg Oncol. 2019;26(2):547\u201354.","journal-title":"Ann Surg Oncol"},{"issue":"10","key":"1221_CR44","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1111\/jop.12870","volume":"48","author":"AE Pilborough","year":"2019","unstructured":"Pilborough AE, Lambert DW, Khurram SA. Extranodal extension in oral cancer: a role for the nodal microenvironment? J Oral Pathol Med. 2019;48(10):863\u201370.","journal-title":"J Oral Pathol Med"},{"issue":"7 Pt 1","key":"1221_CR45","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1177\/000348949910800710","volume":"108","author":"MP Prim","year":"1999","unstructured":"Prim MP, et al. Extracapsular spread and desmoplastic pattern in neck lymph nodes: two prognostic factors of laryngeal cancer. Ann Otol Rhinol Laryngol. 1999;108(7 Pt 1):672\u20136.","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"8","key":"1221_CR46","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1016\/j.ijom.2019.03.900","volume":"48","author":"SK Rajappa","year":"2019","unstructured":"Rajappa SK, et al. Extracapsular extension in oral cavity cancers-predictive factors and impact on recurrence pattern and survival. Int J Oral Maxillofac Surg. 2019;48(8):989\u201394.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"8","key":"1221_CR47","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.1002\/hed.24705","volume":"39","author":"Y Saito","year":"2017","unstructured":"Saito Y, et al. Prognostic value of lymphovascular invasion of the primary tumor in hypopharyngeal carcinoma after total laryngopharyngectomy. Head Neck. 2017;39(8):1535\u201343.","journal-title":"Head Neck"},{"issue":"7","key":"1221_CR48","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.1158\/1078-0432.CCR-17-0721","volume":"24","author":"VC Sandulache","year":"2018","unstructured":"Sandulache VC, et al. High-risk TP53 mutations are associated with extranodal extension in oral cavity squamous cell carcinoma. Clin Cancer Res. 2018;24(7):1727\u201333.","journal-title":"Clin Cancer Res"},{"key":"1221_CR49","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.oraloncology.2017.09.014","volume":"74","author":"J Shevach","year":"2017","unstructured":"Shevach J, et al. Extracapsular extension is associated with worse distant control and progression-free survival in patients with lymph node-positive human papillomavirus-related oropharyngeal carcinoma. Oral Oncol. 2017;74:56\u201361.","journal-title":"Oral Oncol"},{"issue":"4","key":"1221_CR50","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/S0901-5027(99)80158-1","volume":"28","author":"S Shingaki","year":"1999","unstructured":"Shingaki S, et al. The impact of extranodal spread of lymph node metastases in patients with oral cancer. Int J Oral Maxillofac Surg. 1999;28(4):279\u201384.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"5","key":"1221_CR51","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1055\/s-2007-1011073","volume":"170","author":"HJ Steinkamp","year":"1999","unstructured":"Steinkamp HJ, et al. Extracapsular neoplastic spread of cervical lymph node metastasis: Diagnostic value of computed tomography. Rofo. 1999;170(5):457\u201362.","journal-title":"Rofo"},{"issue":"5","key":"1221_CR52","first-page":"314","volume":"18","author":"N Taghavi","year":"2015","unstructured":"Taghavi N, Yazdi I. Prognostic factors of survival rate in oral squamous cell carcinoma: clinical, histologic, genetic and molecular concepts. Arch Iran Med. 2015;18(5):314\u20139.","journal-title":"Arch Iran Med"},{"issue":"5","key":"1221_CR53","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1111\/j.1365-2273.1994.tb01255.x","volume":"19","author":"NS Violaris","year":"1994","unstructured":"Violaris NS, et al. Soft tissue cervical metastases of squamous carcinoma of the head and neck. Clin Otolaryngol Allied Sci. 1994;19(5):394\u20139.","journal-title":"Clin Otolaryngol Allied Sci"},{"issue":"1","key":"1221_CR54","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/S0901-5027(97)80837-5","volume":"26","author":"JA Woolgar","year":"1997","unstructured":"Woolgar JA. Detailed topography of cervical lymph-note metastases from oral squamous cell carcinoma. Int J Oral Maxillofac Surg. 1997;26(1):3\u20139.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"4","key":"1221_CR55","first-page":"237","volume":"76","author":"JA Woolgar","year":"1994","unstructured":"Woolgar JA, et al. Pathological findings in clinically false-negative and false-positive neck dissections for oral carcinoma. Ann R Coll Surg Engl. 1994;76(4):237\u201344.","journal-title":"Ann R Coll Surg Engl"},{"issue":"Suppl 1","key":"1221_CR56","doi-asserted-by":"publisher","first-page":"E1192","DOI":"10.1002\/hed.24190","volume":"38","author":"VB Wreesmann","year":"2016","unstructured":"Wreesmann VB, et al. Influence of extracapsular nodal spread extent on prognosis of oral squamous cell carcinoma. Head Neck. 2016;38(Suppl 1):E1192\u2013E1199199.","journal-title":"Head Neck"},{"issue":"2","key":"1221_CR57","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.ijom.2015.09.005","volume":"45","author":"S Yamada","year":"2016","unstructured":"Yamada S, et al. Evaluation of the level of progression of extracapsular spread for cervical lymph node metastasis in oral squamous cell carcinoma. Int J Oral Maxillofac Surg. 2016;45(2):141\u20136.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"5","key":"1221_CR58","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1002\/lary.27508","volume":"129","author":"JP Agarwal","year":"2019","unstructured":"Agarwal JP, et al. Extranodal extension in resected oral cavity squamous cell carcinoma: more to it than meets the eye. Laryngoscope. 2019;129(5):1130\u20136.","journal-title":"Laryngoscope"},{"issue":"3","key":"1221_CR59","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1016\/j.ijrobp.2005.08.020","volume":"64","author":"S Apisarnthanarax","year":"2006","unstructured":"Apisarnthanarax S, et al. Determining optimal clinical target volume margins in head-and-neck cancer based on microscopic extracapsular extension of metastatic neck nodes. Int J Radiat Oncol Biol Phys. 2006;64(3):678\u201383.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"5","key":"1221_CR60","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1016\/j.ijrobp.2017.12.136","volume":"100","author":"MR Corby","year":"2018","unstructured":"Corby MR, et al. A novel radiographic grading system to evaluate extranodal extension in regional nodal metastases from head and neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys. 2018;100(5):1359\u20131359.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"1221_CR61","first-page":"273a","volume":"23","author":"extraCarpenter DH,","year":"2010","unstructured":"extraCarpenter DH, et al. Extracapsular extension in oropharyngeal squamous cell carcinoma: only soft tissue metastasis predicts disease recurrence but does so independent of HPV status. Mod Pathol. 2010;23:273a\u2013.","journal-title":"Mod Pathol"},{"issue":"4","key":"1221_CR62","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1016\/j.ijrobp.2009.03.065","volume":"76","author":"P Ghadjar","year":"2010","unstructured":"Ghadjar P, et al. Quantitative analysis of extracapsular extension of metastatic lymph nodes and its significance in radiotherapy planning in head and neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys. 2010;76(4):1127\u201332.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"1221_CR63","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1002\/hed.10194","volume":"25","author":"J Jose","year":"2003","unstructured":"Jose J, Coatesworth AP, MacLennan K. Cervical metastases in upper aerodigestive tract squamous cell carcinoma: histopathologic analysis and reporting. Head Neck. 2003;25(3):194\u20137.","journal-title":"Head Neck"},{"issue":"2","key":"1221_CR64","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1001\/archotol.130.2.157","volume":"130","author":"J Jose","year":"2004","unstructured":"Jose J, et al. Soft tissue deposits in neck dissections of patients with head and neck squamous cell carcinoma: prospective analysis of prevalence, survival, and its implications. Arch Otolaryngol Head Neck Surg. 2004;130(2):157\u201360.","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"6","key":"1221_CR65","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1016\/j.jcms.2015.04.021","volume":"43","author":"M Kwon","year":"2015","unstructured":"Kwon M, et al. Extranodal extension and thickness of metastatic lymph node as a significant prognostic marker of recurrence and survival in head and neck squamous cell carcinoma. J Craniomaxillofac Surg. 2015;43(6):769\u201378.","journal-title":"J Craniomaxillofac Surg"},{"issue":"3","key":"1221_CR66","first-page":"327","volume":"59","author":"WL Lodder","year":"2015","unstructured":"Lodder WL, et al. Detection of extranodal spread in head and neck cancer with [18F] FDG PET and MRI: improved accuracy? Q J Nucl Med Mol Imaging. 2015;59(3):327\u201335.","journal-title":"Q J Nucl Med Mol Imaging"},{"key":"1221_CR67","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.oraloncology.2017.05.020","volume":"71","author":"LL Matos","year":"2017","unstructured":"Matos LL, et al. External validation of the AJCC Cancer Staging Manual, 8th edition, in an independent cohort of oral cancer patients. Oral Oncol. 2017;71:47\u201353.","journal-title":"Oral Oncol"},{"issue":"7","key":"1221_CR68","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1016\/j.ijom.2017.12.007","volume":"47","author":"C Michikawa","year":"2018","unstructured":"Michikawa C, et al. Small size of metastatic lymph nodes with extracapsular spread greatly impacts treatment outcomes in oral squamous cell carcinoma patients. Int J Oral Maxillofac Surg. 2018;47(7):830\u20135.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"1","key":"1221_CR69","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1080\/00016480310015399","volume":"124","author":"JW Moor","year":"2004","unstructured":"Moor JW, et al. Upper aerodigestive tract squamous cell carcinoma: distribution of extracapsular spread and soft tissue deposits in the neck. Acta Otolaryngol. 2004;124(1):97\u2013101.","journal-title":"Acta Otolaryngol"},{"issue":"10","key":"1221_CR70","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1002\/cncr.28596","volume":"120","author":"RS Prabhu","year":"2014","unstructured":"Prabhu RS, et al. Extent of pathologic extracapsular extension and outcomes in patients with nonoropharyngeal head and neck cancer treated with initial surgical resection. Cancer. 2014;120(10):1499\u2013506.","journal-title":"Cancer"},{"issue":"1","key":"1221_CR71","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1016\/j.ijrobp.2013.10.002","volume":"88","author":"RS Prabhu","year":"2014","unstructured":"Prabhu RS, et al. Accuracy of computed tomography for predicting pathologic nodal extracapsular extension in patients with head-and-neck cancer undergoing initial surgical resection. Int J Radiat Oncol Biol Phys. 2014;88(1):122\u20139.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"8","key":"1221_CR72","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1016\/j.oraloncology.2015.05.004","volume":"51","author":"P Sinha","year":"2015","unstructured":"Sinha P, et al. Soft tissue metastasis in p16-positive oropharynx carcinoma: prevalence and association with distant metastasis. Oral Oncol. 2015;51(8):778\u201386.","journal-title":"Oral Oncol"},{"issue":"14","key":"1221_CR73","doi-asserted-by":"publisher","first-page":"3519","DOI":"10.1002\/cncr.26671","volume":"118","author":"P Sinha","year":"2012","unstructured":"Sinha P, et al. Extracapsular spread and adjuvant therapy in human papillomavirus-related, p16-positive oropharyngeal carcinoma. Cancer. 2012;118(14):3519\u201330.","journal-title":"Cancer"},{"issue":"1","key":"1221_CR74","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1055\/s-2002-19533","volume":"174","author":"HJ Steinkamp","year":"2002","unstructured":"Steinkamp HJ, et al. Extracapsular spread of cervical lymph node metastases: diagnostic value of magnetic resonance imaging. Rofo. 2002;174(1):50\u20135.","journal-title":"Rofo"},{"issue":"11","key":"1221_CR75","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1055\/s-2007-997061","volume":"77","author":"S Wenzel","year":"1998","unstructured":"Wenzel S, et al. A new histological scheme for the evaluation of cervical lymph node metastases in squamous cell carcinoma of the head and neck. Laryngo-Rhino-Otologie. 1998;77(11): 657\u201362.","journal-title":"Laryngo-Rhino-Otologie"},{"issue":"9","key":"1221_CR76","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1007\/s00106-004-1119-8","volume":"52","author":"S Wenzel","year":"2004","unstructured":"Wenzel S, Koch U. Squamous cell carcinomas of the upper aerodigestive tract. Prognostic significance of the capsular rupture and extracapsular spread of lymph node metastases. HNO. 2004;52(9):783\u20139.","journal-title":"HNO"},{"issue":"10","key":"1221_CR77","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1055\/s-2003-43239","volume":"82","author":"S Wenzel","year":"2003","unstructured":"Wenzel S, et al. Capsular rupture of lymph node metastases as most significant prognostic factor in head and neck squamous cell Carcinomas\u2013Hamburg experiences. Laryngorhinootologie. 2003;82(10):707\u201312.","journal-title":"Laryngorhinootologie"},{"issue":"3","key":"1221_CR78","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1007\/s00784-017-2231-y","volume":"22","author":"SI Yamada","year":"2018","unstructured":"Yamada SI, et al. Progression level of extracapsular spread and tumor budding for cervical lymph node metastasis of OSCC. Clin Oral Investig. 2018;22(3):1311\u20138.","journal-title":"Clin Oral Investig"},{"issue":"4\u20135","key":"1221_CR79","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/j.oraloncology.2008.07.016","volume":"45","author":"JA Woolgar","year":"2009","unstructured":"Woolgar JA, Triantafyllou A. Pitfalls and procedures in the histopathological diagnosis of oral and oropharyngeal squamous cell carcinoma and a review of the role of pathology in prognosis. Oral Oncol. 2009;45(4\u20135):361\u201385.","journal-title":"Oral Oncol"},{"key":"1221_CR80","volume-title":"TNM classification of malignant tumours","author":"J Brierley","year":"2017","unstructured":"Brierley J, Wittekind C, Gospodarowicz MK. TNM classification of malignant tumours. 8th ed. New Jersey: Wiley Blackwell; 2017.","edition":"8"}],"container-title":["Head and Neck Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12105-020-01221-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12105-020-01221-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12105-020-01221-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T18:11:56Z","timestamp":1723572716000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12105-020-01221-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,12]]},"references-count":80,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["1221"],"URL":"https:\/\/doi.org\/10.1007\/s12105-020-01221-4","relation":{},"ISSN":["1936-0568"],"issn-type":[{"value":"1936-0568","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,12]]},"assertion":[{"value":"17 July 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 September 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with Ethical Standards"}},{"value":"The authors declare that they have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This article does not contain any studies with human participants performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}