목적: As growing evidence indicates the better, but heterotypic prognosis in HPV-associated oropharyngeal cancers, there are urgent needs for precise risk stratification for that patients. This study aimed to identify imaging characteristics on computed tomography (CT) scan that are predictive for extranodal extension (ENE) of lymph node metastasis (LNM) in patients with oropharyngeal cancers. 방법:Data were collected from the cohort in Ajou University Hospital Cancer Center. A total 108 oropharyngeal cancer patients were included for analyses. CT scans were reassessed for the presence of multiple factors associated with nodal margin and nodal burden. 결과:CT-based characteristics showed variable degrees of association with ENE. As expected, factors that are associated with nodal margin breakdown (indistinct capsular contour, irregular margin, absence of perinodal fat) were significantly predictive of ENE (HR = 11.472, 8.504, and 15.900, respectively). Interestingly, factors that are associated with the nodal burden (nodal matting, lower neck metastasis, number of LNM > 2) were also significantly predictive of ENE (HR = 25.263, 5.580, and 6.074). The combined utility of the nodal margin and burden factors further increased the predictive ability. 결론:Preoperatively performed CT-based characteristics could relatively accurately predict ENE in patients with oropharyngeal cancers. Detailed analysis indicates not only nodal margin factors but also nodal burden factors were associated with ENE implicating the combination of the nodal margin and burden factors for more accurate ENE prediction.