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However, studies combining histopathological and clinicopathological information in prediction models are limited. We aimed to develop a highly accurate lymph node recurrence prediction model for clinical stage T1\u20102, N0 (cT1\u20102N0) tongue SCC by integrating histopathological artificial intelligence (AI) with clinicopathological information. A dataset from 148 patients with cT1\u20102N0 tongue SCC was divided into training and test sets. The prediction models were constructed using AI\u2010extracted information from whole slide images (WSIs), human\u2010assessed clinicopathological information, and both combined. Weakly supervised learning and machine learning algorithms were used for WSIs and clinicopathological information, respectively. The combination model utilised both algorithms. Highly predictive patches from the model were analysed for histopathological features. In the test set, the areas under the receiver operating characteristic (ROC) curve for the model using WSI, clinicopathological information, and both combined were 0.826, 0.835, and 0.991, respectively. The highest area under the ROC curve was achieved with the model combining WSI and clinicopathological factors. Histopathological feature analysis showed that highly predicted patches extracted from recurrence cases exhibited significantly more tumour cells, inflammatory cells, and muscle content compared with non\u2010recurrence cases. Moreover, patches with mixed inflammatory cells, tumour cells, and muscle were significantly more prevalent in recurrence versus non\u2010recurrence cases. The model integrating AI\u2010extracted histopathological and human\u2010assessed clinicopathological information demonstrated high accuracy in predicting lymph node recurrence in patients with cT1\u20102N0 tongue SCC.<\/jats:p>","DOI":"10.1002\/2056-4538.12392","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T12:40:30Z","timestamp":1724071230000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Predicting lymph node recurrence in\n                    <scp>cT1<\/scp>\n                    \u2010\n                    <scp>2N0<\/scp>\n                    tongue squamous cell carcinoma: collaboration between artificial intelligence and pathologists"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6489-446X","authenticated-orcid":false,"given":"Masahiro","family":"Adachi","sequence":"first","affiliation":[{"name":"Department of Pathology and Clinical Laboratories National Cancer Center Hospital East  Kashiwa Japan"},{"name":"Department of Otolaryngology, Head and Neck Surgery University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Taki","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratories National Cancer Center Hospital East  Kashiwa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motohiro","family":"Kojima","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratories National Cancer Center Hospital East  Kashiwa Japan"},{"name":"Division of Pathology National Cancer Center Exploratory Oncology Research &amp; Clinical Trial Center  Kashiwa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratories National Cancer Center Hospital East  Kashiwa Japan"},{"name":"Division of Pathology National Cancer Center Exploratory Oncology Research &amp; Clinical Trial Center  Kashiwa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuto","family":"Matsuura","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery National Cancer Center Hospital East  Kashiwa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuichi","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery National Cancer Center Hospital East  Kashiwa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiji","family":"Tabuchi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery University of Tsukuba  Tsukuba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shumpei","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Division of Pathology National Cancer Center Exploratory Oncology Research &amp; Clinical Trial Center  Kashiwa Japan"},{"name":"Department of Preventive Medicine, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genichiro","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratories National Cancer Center Hospital East  Kashiwa Japan"},{"name":"Division of Innovative Pathology and Laboratory Medicine National Cancer Center Exploratory Oncology Research &amp; Clinical Trial Center  Kashiwa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Sakashita","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratories National Cancer Center Hospital East  Kashiwa Japan"},{"name":"Division of Pathology National Cancer Center Exploratory Oncology Research &amp; Clinical Trial Center  Kashiwa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.02855"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.1281"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506007"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.01.016"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.01921"},{"key":"e_1_2_8_7_1","unstructured":"National Comprehensive Cancer Network.NCCN Clinical Practice Guidelines in Oncology Head and Neck Cancers Version 42024. 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