A multimodal biological margin risk index predicts recurrence after neoadjuvant immunochemotherapy in head and neck squamous cell carcinoma.

ABSTRACT:

Background

Conventional classification of surgical margins is inadequate for head and neck squamous cell carcinoma (HNSCC) treated with neoadjuvant immunochemotherapy (NICT), as it fails to capture the complex biological changes in the tumor microenvironment. This study aimed to develop a novel definition of a negative margin.

Methods

We conducted a retrospective analysis of treatment-naïve, HPV-negative HNSCC patients who completed NICT followed by surgery. Surgical margins underwent multi-modal assessment, including histopathology (tertiary lymphoid structures), tumor burden (Pan-CK, Ki-67), molecular profiling (driver mutations, PD-L1 RNA), and immune contexture (CD8+/FoxP3+ ratio, Granzyme B). A Margin Risk Index (MRIx) was developed by weighting these domains based on t

SUBMITTER: Xu N 

PROVIDER: S-EPMC12920489 | biostudies-literature | 2026

REPOSITORIES: biostudies-literature