Faculty Collaboration Database

Tumoral Skin Invasion Is an Independent Predictor of Rapid Recurrence in Head and Neck Cancer. Head Neck 2026 Feb;48(2):535-542

Date

10/07/2025

Pubmed ID

41054923

DOI

10.1002/hed.70066

Scopus ID

2-s2.0-105018525815 (requires institutional sign-in at Scopus site)

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.

Author List

Memon AA, Khalil M, Espinosa OV, Said I, Yang E, Adams JA, Friedland DR, Khani M, Luo J, Kuehn R, Frei A, Foeckler J, Akakpo K, Massey B, Stadler M, Wong S, Himburg HA, Awan MJ, Bruening J, Zenga J

Authors

Musaddiq J. Awan MD Associate Professor in the Radiation Oncology department at Medical College of Wisconsin
Jennifer D. Bruening MD Assistant Professor in the Otolaryngology and Communication Sciences department at Medical College of Wisconsin
Heather A. Himburg PhD Professor in the Radiation Oncology department at Medical College of Wisconsin
Jake Luo Ph.D. Associate Professor; Director, Center for Biomedical Data and Language Processing (BioDLP) in the Health Informatics & Administration department at University of Wisconsin - Milwaukee
Becky Massey MD Associate Professor in the Otolaryngology and Communication Sciences department at Medical College of Wisconsin
Abdullah A. Memon Predoctoral Research Scholar in the Cancer Center department at Medical College of Wisconsin
Michael Stadler MD Associate Professor in the Otolaryngology and Communication Sciences department at Medical College of Wisconsin
Stuart J. Wong MD Center Director, Professor in the Medicine department at Medical College of Wisconsin
Joseph Zenga MS, MD Chief, Associate Professor in the Otolaryngology and Communication Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Female
Head and Neck Neoplasms
Humans
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Retrospective Studies
Risk Assessment
Skin Neoplasms