Discordant Responses Between Imaging Examination and Surgical Pathology of Head and Heck Squamous Cell Carcinoma After Neoadjuvant Immunotherapy Combined With Chemotherapy
Bibliographic record
Abstract
Background: We here investigated the value of imaging examination in evaluating tumor remission-based surgery in patients with head and neck squamous cell carcinoma (HNSCC), who had undergone neoadjuvant immunotherapy combined with chemotherapy (NICC). Methods: HNSCC patients who underwent NICC and surgery from May 2021 to September 2023 were retrospectively analyzed. All patients had to undergo imaging examination evaluation, including enhanced computed tomography (CT) and enhanced magnetic resonance (MR) imaging before and after NICC. Data related to clinical parameters, complete response of the primary site (PrCR), complete response of the primary site and the lymph node (PLCR), complete response of the lymph node (LCR), and tumor response (TR), were gathered. The paired Chi-square test and t-test were conducted to analyze the differences in responses between imaging examination and pathology. Binary logistic regression was applied to analyze the relevant clinical factors of differences in responses. Results: In total, data of 41 patients were included in this study. Significant discordant responses were observed between enhanced CT, magnetic resonance imaging (MRI), and pathology in PrCR (4.9%, 7.3% vs. 41.5%), LCR (12.2%, 7.3% vs. 53.7%), PLCR (0%, 0% vs. 31.7%), and TR (severe 29.3%,17.1% vs. 25.61%) (P < 0.05). Patients with hypopharyngeal cancer (odds ratio (OR): 7.04), oral cancer (OR: 3.64), higher neutrophil to lymphocyte ratio (NLR) (OR: 2.05), and earlier T stage (OR: 0.71) exhibited a larger response difference between enhanced CT and pathology. Patients with younger age (OR: 0.79) hypopharyngeal cancer (OR: 22.81), oral cancer (OR: 2.65), higher NLR (OR: 19.47), and earlier T stage (OR: 0.29) exhibited a larger response difference between enhanced MR and pathology. Conclusions: Discordant responses were noted between the imaging examination and surgical pathology of HNSCC after NICC. Hypopharyngeal cancer, higher NLR, and earlier T stage may predict a higher response difference.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".