Re: Extracapsular tumor extension in cervical lymph nodes: reconciling the literature and seer data.

BACKGROUND Extracapsular extension (ECE) of disease from cervical lymph nodes (LNs) is an important prognostic factor for head and neck cancers; moreover, the presence of ECE has been shown to be a criterion for the addition of chemotherapy to postoperative radiation. METHODS We reviewed the frequency of ECE in the Surveillance, Epidemiology, and End Results (SEER) registry database, particularly as it related to nodal size. Our objective was to compare these findings with the literature. RESULTS SEER data suggest that the likelihood of ECE does not increase linearly with LN size, whereas most reports in the literature suggest that the likelihood of ECE does increase with increasing LN size. CONCLUSIONS SEER data and the literature are not consistent in describing the relationship between ECE and LN size. These results suggest the need for better standardization in the assessment and reporting of ECE.