{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T08:21:20Z","timestamp":1783153280066,"version":"3.54.6"},"reference-count":44,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["febs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Molecular Oncology"],"abstract":"<jats:p>\n                    Head and neck squamous cell carcinoma (HNSCC) is associated with high locoregional recurrence and poor survival despite multimodal treatment. Reliable biomarkers to guide personalized therapy remain lacking. Circulating tumor cells (CTCs) represent a promising tool, but their clinical utility in HNSCC is insufficiently defined. In this cohort study, 30 stage I\u2013IVb HNSCC patients undergoing curative\u2010intent surgery were enrolled. Preoperative blood samples were analyzed using the FDA\u2010approved CellSearch\u2122 system for CTC count and Programmed death\u2010ligand 1 (PD\u2010L1) expression. Prognostic associations were assessed using Kaplan\u2013Meier analysis and Cox regression. Combined risk models integrating CTC status with radiological features were explored. CTCs were detected in 37.9% (11\/29) of patients. CTC positivity was significantly associated with reduced overall survival (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.031). Univariate and bootstrap\u2010adjusted Cox regression identified CTC presence and tumor volume as factors associated with overall survival. Integrating CTC status with tumor volume or nodal stage improved patient stratification, identifying a high\u2010risk group with shorter recurrence\u2010free and overall survival. Preoperative CTC detection may serve as a prognostic biomarker in HNSCC and enhances risk stratification when combined with imaging\u2010derived tumor characteristics, supporting liquid biopsy integration into pre\u2010surgical evaluation.\n                  <\/jats:p>","DOI":"10.1002\/1878-0261.70299","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T08:07:54Z","timestamp":1783152474000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative circulating tumor cells integrated with imaging analysis for prognostic evaluation in head and neck squamous cell carcinoma"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6196-3706","authenticated-orcid":false,"given":"Susanne","family":"Flach","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery LMU University Hospital, LMU Munich  Germany"},{"name":"German Cancer Consortium (DKTK), Partner Site Munich  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gizem","family":"Abaci","sequence":"additional","affiliation":[{"name":"Department of Radiology LMU University Hospital, LMU Munich  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Huberty","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery LMU University Hospital, LMU Munich  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Lechner","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery LMU University Hospital, LMU Munich  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"K\u00e4smann","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology LMU University Hospital, LMU Munich  Germany"},{"name":"Department of Radiation Oncology Klinikum Landshut  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Ricke","sequence":"additional","affiliation":[{"name":"Department of Radiology LMU University Hospital, LMU Munich  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"St\u00f6cklein","sequence":"additional","affiliation":[{"name":"Department of Radiology LMU University Hospital, LMU Munich  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Canis","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery LMU University Hospital, LMU Munich  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Baumeister","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery LMU University Hospital, LMU Munich  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Alunni\u2010Fabbroni","sequence":"additional","affiliation":[{"name":"Department of Radiology LMU University Hospital, LMU Munich  Germany"},{"name":"European Liquid Biopsy Society (ELBS)  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2025.1547311","article-title":"Real\u2010world treatment patterns and survival outcomes in patients with locally advanced squamous cell carcinoma of the head and neck in Germany using claims data","volume":"15","author":"Hering K","year":"2025","journal-title":"Front Oncol"},{"issue":"2","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejso.2025.111357","article-title":"Circulating tumor cells predict relapse in head and neck mucosal squamous cell 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