Personalized Prediction of Lymph Node Involvement in Head and Neck Squamous Cell Carcinomas Using Mixture Hidden Markov Models Incorporating Tumor

Personalized Prediction of Lymph Node Involvement in Head and Neck Squamous Cell Carcinomas Using Mixture Hidden Markov Models Incorporating Tumor | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Personalized Prediction of Lymph Node Involvement in Head and Neck Squamous Cell Carcinomas Using Mixture Hidden Markov Models Incorporating Tumor Latha This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8412125/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Head and neck squamous cell carcinomas (HNSCC) frequently metastasize to regional lymph nodes, making accurate prediction of lymphatic spread crucial for treatment planning. Current diagnostic imaging techniques fall short in detecting microscopic lymph node metastases, often leading to broad and non-personalized irradiation strategies. In this study, we present an advanced model for predicting the risk of occult nodal disease by integrating the primary tumor location into a hidden Markov model (HMM) framework. We focus on tumors in the oropharynx and oral cavity, incorporating detailed subsites as defined by ICD-10 codes. By leveraging multi-centric data from over 1,200 patients, we developed a mixture of HMMs that account for the distinct patterns of lymphatic spread observed in different tumor subsites. Our approach enhances the precision of lymph node involvement predictions, potentially allowing for more personalized and targeted radiation therapy. The results indicate that our mixture model outperforms traditional models, especially in cases where lymph node involvement patterns vary significantly across subsites. This work represents a significant step towards personalized treatment planning in HNSCC, with the potential to reduce treatment-related side effects while maintaining therapeutic efficacy. Oncology Head and Neck Squamous Cell Carcinoma (HNSCC) Lymph Node Metastasis Hidden Markov Model (HMM) Predictive Modeling Personalized Radiation Therapy Occult Nodal Disease Tumor Subsite ICD‑10 Mixture Models Treatment Planning Full Text Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8412125","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":563391327,"identity":"b430d727-80b5-480e-9616-1d3854637f7b","order_by":0,"name":"Latha","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABEElEQVRIiWNgGAWjYBACPgYGNgaGAxJAJvOBAx//2AAZjI0H8GlhY2CGaWFLfDizIQ2kpYEYLSAmj7Exb8NhsCh+Leznjz34ccYin392g5kE747zdmvbDwNtqbGJxqmFJ5ndsOeGhOWMOwfSJCTP3E7ediYRqOVYWm4DTocls0nwfJAwYLiRcEzCgO12stkBoBbGhsO4tfA/ZpP8A9QifyOxTSKB7Vyy2fmHBLRIJLNJ89yQMDC4kcxscLDtgJ3ZDUK2SDw2k5Y5I2FgeCON8WHDmeQEsxtAWxLw+IWfP/GZ5JtjdQZyN/I/HP5TYWdvdj794YMPNTY4tWCARLDKBGKVg4A9KYpHwSgYBaNgZAAA1dJkn5IrZz4AAAAASUVORK5CYII=","orcid":"","institution":"Vydehi Institute of Medical Sciences and Research Centre","correspondingAuthor":true,"prefix":"","firstName":"","middleName":"","lastName":"Latha","suffix":""}],"badges":[],"createdAt":"2025-12-20 12:27:55","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8412125/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8412125/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":99308875,"identity":"343f22e5-80b4-45fc-a369-b7bb0c379fd1","added_by":"auto","created_at":"2025-12-31 16:09:24","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":194143,"visible":true,"origin":"","legend":"","description":"","filename":"PersonalizedPredictionofLymphNodeInvolvementinHeadandNeckSquamousCellCarcinomasUsingMixtureHiddenMarkovModelsIncorporatingTumor14.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8412125/v1_covered_09b89546-5ab0-422a-9adc-cb03bf4ae33c.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003ePersonalized Prediction of Lymph Node Involvement in Head and Neck Squamous Cell Carcinomas Using Mixture Hidden Markov Models Incorporating Tumor\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Independent University of Moscow","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Head and Neck Squamous Cell Carcinoma (HNSCC), Lymph Node Metastasis, Hidden Markov Model (HMM), Predictive Modeling, Personalized Radiation Therapy, Occult Nodal Disease, Tumor Subsite, ICD‑10, Mixture Models, Treatment Planning","lastPublishedDoi":"10.21203/rs.3.rs-8412125/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8412125/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eHead and neck squamous cell carcinomas (HNSCC) frequently metastasize to regional lymph nodes, making accurate prediction of lymphatic spread crucial for treatment planning. 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This work represents a significant step towards personalized treatment planning in HNSCC, with the potential to reduce treatment-related side effects while maintaining therapeutic efficacy.\u003c/p\u003e","manuscriptTitle":"Personalized Prediction of Lymph Node Involvement in Head and Neck Squamous Cell Carcinomas Using Mixture Hidden Markov Models Incorporating Tumor","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-23 03:44:15","doi":"10.21203/rs.3.rs-8412125/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3f5764de-55b9-4870-bf75-a5addf45eed7","owner":[],"postedDate":"December 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":59997918,"name":"Oncology"}],"tags":[],"updatedAt":"2025-12-23T03:44:15+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-23 03:44:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8412125","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8412125","identity":"rs-8412125","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}