CT radiomics of primary tumor and lymph nodes predicts 5-year recurrence in HPV+ oropharyngeal cancer

In a retrospective study of 716 patients, a multi-regional CT radiomics model combining primary and nodal features predicted 5-year recurrence in HPV+ oropharyngeal cancer with AUCs of 0.907 (training), 0.852 (internal validation), and 0.835 (external test), outperforming single…

• 716 patients from three independent datasets: training (390), internal validation (166), external test (160); multi-regional XGBoost model.
• Integration of primary tumor and lymph node features improved risk reclassification (NRI 0.242, IDI 0.097) vs. primary-only radiomics.
• Retrospective design; model requires prospective validation before clinical adoption.

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