BACKGROUND: The AJCC cutoff value of 2 mm for the extranodal extension (ENE) distance was determined from an analysis of patients with or without adjuvant therapy. The purpose of this study was to find out the ENE distance that reflects prognosis only in patients with head and neck squamous cell carcinoma (SCC) who received adjuvant therapy. METHODS: The ENE distance was defined for 109 patients who underwent surgery for SCC of larynx or hypopharynx as a primary tumor. RESULTS: To standardize patient conditions, only 26 patients who received additional postoperative treatment were analyzed. Receiver operating characteristic analysis of the ENE distance for overall survival (OS) and recurrence-free survival (RFS) yielded a cutoff value of 4250 mum. Multivariate analysis showed that the ENE distance was an independent poor prognostic factor for OS and RFS. CONCLUSION: The optimal ENE distance cutoff for OS and RFS in postoperatively treated patients was 4250 mum.
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