CONCLUSIONS
HNSCC
TDs in HNSCC were present in 29.6% of patients, and their presence was associated with a lower 3‐year OS rate compared to ENE cases, despite intensified adjuvant therapy with surgery followed by CTX‐RT. The results confirm a better prognosis for pN2a‐ENE compared to pN3b‐ENE, and for pN3b‐ENE compared to TDs. Furthermore, the findings of this study suggest that TDs could be an important prognostic indicator in HNSCC, and their inclusion in the TNM staging system could provide a more accurate stratification of different risk groups. Further studies with larger sample sizes are needed to confirm these results and to evaluate the impact of TDs on treatment strategies and patient outcomes in HNSCC.