Development and validation of a prognostic model to predict survival in head and neck cancer patients with extranodal extension

This is a multicentric retrospective study being conducted at All India Institute of Medical Sciences  New Delhi and Rajiv Gandhi Cancer Institute & Research Centre  New Delhi. The study aims to develop and validate a prognostic model to predict survival outcomes in patients with head and neck squamous cell carcinoma who have pathological Extranodal extension.

Despite receiving standard adjuvant chemoradiotherapy, patients with extranodal extension continue to have poor prognosis with high rates of recurrence. It is unclear whether additional pathological factors such as number of positive nodes, extent of extra nodal extension, tumor subsite, higher T stage, depth of invasion, and margin status independently influence outcomes and necessitate treatment escalation.

In this study, clinicopathological data of patients with extra nodal extension will be collected from both centres. A Cox proportional hazards model will be used to construct and validate a multivariable prognostic model, with internal validation through repeated random split-sample cross-validation and bootstrapping. The expected outcome is the development of a clinically applicable nomogram to identify a high-risk subset of patients with ENE who may be candidates for future trials on treatment intensification.

The findings are anticipated to provide an evidence-based tool for risk stratification and treatment decision-making in head and neck cancer patients with extra nodal extension.