{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T21:24:53Z","timestamp":1769635493104,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100021528","name":"Advancing a Healthier Wisconsin Endowment","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100021528","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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\u2010interval recurrence (SIR) and standard recurrence (SR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective 10\u2010year review of 246 HNSCC patients undergoing surgery with adjuvant therapy. Recurrence was categorized as RR (prior to initiation of adjuvant therapy), SIR (\u2264\u20096\u2009months post\u2010adjuvant therapy), and SR (&gt;\u20096\u2009months post\u2010adjuvant therapy). Univariate analysis (UVA), multivariate analysis (MVA), and machine learning Random Forest models were employed to identify predictors of each recurrence interval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 246 patients, 89 recurred (45 SR, 27 SIR, 17 RR). On MVA, skin invasion (OR\u2009=\u20093.492,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039) was a unique predictor of RR. Random Forest feature importance also revealed skin invasion, along with nodal status, tobacco pack\u2010years, and tumor size as predictors with strong performance (accuracy 93%, AUC 0.96, F1 0.93).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Skin invasion is a unique independent predictor of RR, confirmed by two statistical models. These patients warrant further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70066","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T09:26:30Z","timestamp":1759829190000},"page":"535-542","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tumoral Skin Invasion Is an Independent Predictor of Rapid Recurrence in Head and Neck Cancer"],"prefix":"10.1002","volume":"48","author":[{"given":"Abdullah A.","family":"Memon","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Khalil","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oscar Villarreal","family":"Espinosa","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imaad","family":"Said","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jazzmyne A.","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Friedland","sequence":"additional","affiliation":[{"name":"Caruso Department of Otolaryngology \u2013 Head &amp; Neck Surgery, Keck School of Medicine Of the University of Southern California  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3131-0661","authenticated-orcid":false,"given":"Masoud","family":"Khani","sequence":"additional","affiliation":[{"name":"Department of Health Informatics University of Wisconsin \u2013 Milwaukee  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jake","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Health Informatics University of Wisconsin \u2013 Milwaukee  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Kuehn","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Frei","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie","family":"Foeckler","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Medical College of Wisconsin  Milwaukee Wisconsin USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Akakpo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Sciences Medical College of Wisconsin  Milwaukee Wisconsin 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\u201cMerck's KEYTRUDA (pembrolizumab) Met Primary Endpoint of Event\u2010Free Survival (EFS) as Perioperative Treatment Regimen in Patients With Resected Locally Advanced Head and Neck Squamous Cell Carcinoma \u201dhttps:\/\/www.merck.com\/news\/mercks\u2010keytruda\u2010pembrolizumab\u2010met\u2010primary\u2010endpoint\u2010of\u2010event\u2010free\u2010survival\u2010efs\u2010as\u2010perioperative\u2010treatment\u2010regimen\u2010in\u2010patients\u2010with\u2010resected\u2010locally\u2010advanced\u2010head\u2010and\u2010neck\u2010squamous\u2010c\/."}],"container-title":["Head &amp; 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