Head Neck. 2025 Oct 7. doi: 10.1002/hed.70066. Online ahead of print.
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.
PMID:41054923 | DOI:10.1002/hed.70066
