Radiographic extracapsular extension and treatment outcomes in locally advanced oropharyngeal carcinoma

Benjamin H. Kann, Michael Buckstein, Todd J. Carpenter, Richard Bakst, Krzysztof Misiukiewicz, Eric Genden, Marshall Posner, Lale Kostakoglu, Peter Som, Vishal Gupta

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Background. Pathologic extracapsular extension (pECE) in metastatic lymph nodes is associated with poor prognosis for oropharyngeal carcinoma. The prognostic value of radiographic extracapsular extension (rECE) has not been studied.

Methods. A retrospective analysis was conducted of 111 patients with locally advanced oropharyngeal carcinoma treated in the Mount Sinai Radiation Oncology Department with accessible pretreatment CT reports. Univariate Kaplan-Meier and multivariate Cox regression analyses compared cohorts for locoregional control, distant control, progression-free (PFS), and overall survival (OS).

Results. Sixty-four patients had rECE-present and 47 had rECE-absent scans. The patients with rECE presence had significantly worse OS (3- year: 95% vs 77%; p 5 .006), PFS (3-year: 91% vs 71%; p 5 .002), and distant control (3-year: 98% vs 81%; p 5 .008), with no difference in locoregional control. On multivariate analysis, rECE-presence was a negative prognosticator for OS, PFS, and distant control.

Conclusion. This study suggests that rECE is an independent prognosticator of poor distant control and survival with little impact on locoregional control for oropharyngeal carcinoma.

Original languageEnglish
Pages (from-to)1689-1694
Number of pages6
JournalHead and Neck
Issue number12
StatePublished - 1 Dec 2014


  • Extracapsular extension
  • Neoplasm metastasis
  • Oropharyngeal neoplasms
  • Radiology
  • Squamous cell carcinoma


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