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Poster Discussion – Head and neck cancer

5959 - Efficacy Evaluation of Optimal Patient Selection for Hypopharyngeal Cancer Organ Preservation Therapy using MRI-derived Radiomic Signature: Bi-institutional Propensity Score Matched Analysis


28 Sep 2019


Poster Discussion – Head and neck cancer


Shih-min Lin


Annals of Oncology (2019) 30 (suppl_5): v449-v474. 10.1093/annonc/mdz252


S. Lin1, C. Hsu2, Y. Lee3, T. Li4, S. Kuo5, W. Wang6

Author affiliations

  • 1 Radiation Oncology, Chang Gung Medical Foundation - Linkou Chang Gung Memorial Hospital, 33305 - Taoyuan City/TW
  • 2 Department Of Oncology, National Taiwan university hostipal, 10048 - Taipei/TW
  • 3 Mathematics, National Taiwan University, 10617 - Taipei/TW
  • 4 Radiation Oncology, National Taiwan University Hospital, 10002 - Taipei City/TW
  • 5 Department Of Oncology, National Taiwan University Hospital, 10002 - Taipei City/TW
  • 6 Institute Of Applied Mathematical Sciences, National Taiwan University, 10617 - Taipei/TW


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Abstract 5959


Early loco-regional failure (LRF) after organ preservation therapy (OPT) varies widely for hypopharyngeal squamous cell carcinoma (HPSCC) patients. We aim to develop and validate a MRI-derived radiomic signature RS for the prediction of 1-year LRF in HPSCC treated with OPT, and investigate its efficacy between OPT and total laryngectomy (TL) cohort.


A total of 3912 MRI-based radiomic features (RF) of pretreatment tumors were obtained from 370 HPSCC patients, including OPT cohort1 (OPT1; n = 186), OPT cohort2 (OPT2; n = 88), and TL cohort (TLc; n = 96). Variational autoencoder (VAE), trained with symmetric two encoded and decoded layers of neural network was applied to reduce the dimensionality of original RF to 128 VAE-RF. Least absolute shrinkage and selection operator with 10-fold cross validation performs features selection and constructs RS to predict 1-year LRF events in OPT1, which was validated in OPT2 and TLC. Harrell’s C-index was used to evaluate the discriminative ability of RS. Optimal cut-point for dichotomized RS risk category was determined via Youden index. Pair-wise propensity score matching (caliper 0.2) using pre-treatment variables (age, gender, TNM stage) was applied to compare the impact of OPT and TL under different RS risk categories.


The RS yielded 1000 times bootstrapping corrected C-index of 0.753, 0.745 and 0.398 in the OPT1, OPT2 and TLC, respectively. Dichotomized risk category using Youden cut-point of RS yielded 1 year LRF predictive accuracy of 71.12%, 70.41%, and 41.74% in OPT1, OPT2 and TLC, respectively. In RS-high risk group, OPT were associated with poor progression-free survival (PFS, HR: 1.752, p = 0.032), while in RS-low risk group, OPT did not deteriorate the PFS (HR: 0.774, p = 0.416).


The RS-based model provides a novel to predict 1-year LRF and survival in patients with HPSCC who received OPT. The prediction performance discrepancy of MRI-derived RS in TLC also emphasizes the role of TL in RS-high risk group.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.


Has not received any funding.


All authors have declared no conflicts of interest.

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