Retrospective cohort study of prognostic relevance of preoperative CTCs plus imaging analysis in head and neck squamous cell carcinoma

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 are lacking. A retrospective study at LMU Hospital (Munich, Germany) evaluated preoperative circulating tumor cells (CTCs) combined with radiological features as prognostic biomarkers. The study included 30 patients with stage I-IVb HNSCC undergoing curative-intent surgery. Preoperative CTCs were detected in 11 of 29 patients (37.9%). Both presence of preoperative CTCs and tumor volume higher than the median were associated with reduced overall survival. Integrating preoperative CTC status with tumor volume or nodal stage improved patient stratification, identifying a high-risk group with shorter recurrence-free and overall survival. The authors conclude that preoperative CTC detection may serve as a prognostic biomarker in HNSCC and enhances risk stratification when combined with imaging-derived tumor characteristics.