Evidence map›Paper›PMID 42572045›Full record

ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Nodal fusion and soft tissue invasion provide incremental risk stratification in pathologically N3b classification hypopharyngeal squamous cell carcinoma.

Feiran Li, Simin Liang, Hongli Gong, Huiying Huang, Lei Tao, Liang Zhou, Chi-Yao Hsueh, Ming Zhang

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Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Feiran Li *Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, China.
Simin Liang *Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, China.
Hongli Gong *Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, China.
Huiying HuangDepartment of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, China.
Lei TaoDepartment of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, China.
Liang ZhouDepartment of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, China.
Chi-Yao HsuehDepartment of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, China.
Ming ZhangDepartment of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, 83 Fen Yang Road, Shanghai, China. ent_zhm@126.com.ORCID http://orcid.org/0000-0003-2909-8446

Funding

National Natural Science Foundation of China 82203727National Natural Science Foundation of China 82273097Natural Science Foundation of Shanghai 23ZR1409700Shanghai Municipal Key Clinical Specialty shslczdzk00801Shanghai Sailing Program 22YF1405700
6 · The paper itself

Abstract

backgroundHypopharyngeal squamous cell carcinoma (HPSCC) patients with extranodal extension (ENE) are classified as pN3b and have the poorest prognosis. However, further risk stratification within this high-risk subgroup remains controversial.

methodsWe retrospectively reviewed 141 HPSCC patients who underwent neck dissection and whose disease was confirmed as pN3b at our hospital between January 2012 and December 2021. The primary endpoint was disease-free survival (DFS). Survival analysis was performed using the Kaplan‒Meier method with the log-rank test for group comparisons. Multivariable analysis was conducted using Cox proportional hazards regression.

resultsCompared with patients without lymph node fusion (LNF, n = 30), those with LNF (n = 111) had significantly worse overall survival (OS, P = 0.0177), DFS (P = 0.0302), and distant metastasis-free survival (DMFS, P = 0.0404). Notably, patients with both LNF and soft tissue invasion (STI, n = 17) exhibited the poorest outcomes, with a median OS of only 19 months (95% CI: 4.210-33.790). Compared with patients with LNF alone (n = 94), those with both LNF and STI had significantly shorter OS (P = 0.0385), DFS (P = 0.0032), and regional recurrence-free survival (RFS, P = 0.0143). Multivariable analysis revealed that LNF and pT classification were independent risk factors for the entire pN3b cohort, whereas STI and pT classification were independent risk factors specifically for the LNF-positive subgroup.

conclusionWe identified two candidate prognostic features (LNF and STI) for pN3b HPSCC patients. These findings may assist clinicians in identifying high-risk patients and guiding more personalized treatment decisions.

Indexed as

Extranodal extensionHypopharyngeal squamous cell carcinomaLymph node fusionPrognostic predictionSoft tissue invasion

Identifiers

PMID42572045

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.