Tumoral Skin Invasion Is an Independent Predictor of Rapid Recurrence in Head and Neck Cancer.

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-10-07 DOI:10.1002/hed.70066

Abdullah A Memon, Mohamed Khalil, Oscar Villarreal Espinosa, Imaad Said, Eric Yang, Jazzmyne A Adams, David R Friedland, Masoud Khani, Jake Luo, Rachel Kuehn, Anne Frei, Jamie Foeckler, Kenneth Akakpo, Becky Massey, Michael Stadler, Stuart Wong, Heather A Himburg, Musaddiq J Awan, Jennifer Bruening, Joseph Zenga

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引用次数: 0

Abstract

Background: Head and neck squamous cell carcinoma (HNSCC) is an aggressive malignancy, with 50% of patients recurring. A subset of patients experience rapid recurrence (RR) postoperatively but prior to adjuvant therapy. This study identifies factors associated with RR and additional recurrence intervals: short-interval recurrence (SIR) and standard recurrence (SR).

Methods: Retrospective 10-year review of 246 HNSCC patients undergoing surgery with adjuvant therapy. Recurrence was categorized as RR (prior to initiation of adjuvant therapy), SIR (≤ 6 months post-adjuvant therapy), and SR (> 6 months post-adjuvant therapy). Univariate analysis (UVA), multivariate analysis (MVA), and machine learning Random Forest models were employed to identify predictors of each recurrence interval.

Results: Of the 246 patients, 89 recurred (45 SR, 27 SIR, 17 RR). On MVA, skin invasion (OR = 3.492, p = 0.039) was a unique predictor of RR. Random Forest feature importance also revealed skin invasion, along with nodal status, tobacco pack-years, and tumor size as predictors with strong performance (accuracy 93%, AUC 0.96, F1 0.93).

Conclusion: Skin invasion is a unique independent predictor of RR, confirmed by two statistical models. These patients warrant further study.

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肿瘤皮肤侵袭是头颈癌快速复发的独立预测因子。

背景：头颈部鳞状细胞癌（HNSCC）是一种侵袭性恶性肿瘤，50%的患者复发。一部分患者术后但在辅助治疗前经历快速复发（RR）。本研究确定了与RR和其他复发间隔相关的因素：短间隔复发（SIR）和标准复发（SR）。方法：对246例接受手术辅助治疗的HNSCC患者进行10年回顾性分析。复发分为RR（开始辅助治疗前）、SIR（辅助治疗后≤6个月）和SR（辅助治疗后≤6个月）。采用单变量分析（UVA）、多变量分析（MVA）和机器学习随机森林模型来识别每个递归区间的预测因子。结果：246例患者中，89例复发（SR 45例，SIR 27例，RR 17例）。在MVA中，皮肤侵袭（OR = 3.492, p = 0.039）是唯一的RR预测因子。随机森林特征的重要性还表明，皮肤侵袭、淋巴结状态、烟草包年和肿瘤大小作为预测指标具有很强的性能（准确率93%，AUC 0.96, F1 0.93）。结论：皮肤侵袭是一个独特的独立的RR预测因子，两个统计模型证实了这一点。这些患者值得进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.