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Inter-observer agreement in assessment of clinically overt extra nodal extension (cN3b)
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  • Emily Chiang,
  • Jo-Lyn McKenzie,
  • Zachary Drew,
  • Jennifer Gillespie,
  • Sarju Vasani
Emily Chiang
Royal Brisbane and Women's Hospital
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Jo-Lyn McKenzie
Royal Brisbane and Women's Hospital
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Zachary Drew
Royal Brisbane and Women's Hospital
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Jennifer Gillespie
Royal Brisbane and Women's Hospital
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Sarju Vasani
Royal Brisbane and Women's Hospital
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Abstract

Key Points • Clinical N3b staging is defined as unequivocal and unambiguous signs of extra nodal extension (ENE), such as skin involvement, muscle invasion or nerve dysfunction, supported by radiological evidence. • There is a paucity of studies determining interobserver reliability of clinical detection of overt ENE. • A prospective comparative cohort study assessing 12 Head and Neck surgeons’ inter-observer agreement in detecting the components of overt ENE. • We reveal high surgeon agreement in the ability to detect lymph nodes, the presence of skin involvement and in surrounding nerve involvement. • Variability of surgeon assessment was seen in the assessment of overt muscular involvement.