【Abstract】Objective Extranodal extension (ENE) is commonly seen in cervical node metastasis of nasopharyngeal carcinoma(NPC),however, the prognostic value of ENE is contradictory. In the present study, we evaluated the prognostic value of ENE in patients with NPC using a propensity scorematched analysis(PSM).Methods 294 patients with NPC and receiving intensitymodulated radiotherapy(IMRT) were retrospectively analyzed. Patients with ENE and without ENE were matched using PSM method. Survival analysis was analyzed with KaplanMeier method, logrank test and Cox regression.Results The incidence of ENE was 520%.ENE was characterized by a higher incidence of cervical nodal necrosis, a larger node diameter size and higher N stage. In the original cohort, ENE was significantly associated with poorer 5year distant metastasisfree survival(DMFS)(654 vs. 769 %, P=0020), progressionfree survival(PFS)(575 vs. 723 %, P=0006) and overall survival(OS)(713 vs. 839 %, P=0028). In the propensitymatched cohort, no significant survival differences were observed between the two groups (local recurrencefree survival(LRFS): 920% vs. 924%, P=0656; regional recurrencefree survival(RRFS):973 % vs. 955%, P=0474; DMFS: 710 % vs. 706%, P=0801; PFS: 659% vs. 628%, P=0907; OS: 757% vs. 800%,P=0558). Multivariate COX regression analysis confirmed that ENE is not an independent prognostic factor for the survival of NPC.Conclusion ENE is not an independent prognostic factor for patients with NPC treated with IMRT. 