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Coudray N, Juarez MC, Criscito MC, Quiros AC, Wilken R, Cullison SRJ, Stevenson ML, Doudican NA, Yuan K, Aquino JD, Klufas DM, North JP, Yu SS, Murad F, Ruiz E, Schmults CD, Tsirigos A, Carucci JA. Self-supervised artificial intelligence predicts recurrence, metastasis and disease specific death from primary cutaneous squamous cell carcinoma at diagnosis. RESEARCH SQUARE 2023:rs.3.rs-3607399. [PMID: 38168253 PMCID: PMC10760225 DOI: 10.21203/rs.3.rs-3607399/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Primary cutaneous squamous cell carcinoma (cSCC) is responsible for ~10,000 deaths annually in the United States. Stratification of risk of poor outcome (PO) including recurrence, metastasis and disease specific death (DSD) at initial biopsy would significantly impact clinical decision-making during the initial post operative period where intervention has been shown to be most effective. In this multi-institutional study, we developed a state-of-the-art self-supervised deep-learning approach with interpretability power and demonstrated its ability to predict poor outcomes of cSCCs at the time of initial biopsy. By highlighting histomorphological phenotypes, our approach demonstrates that poor differentiation and deep invasion correlate with poor prognosis. Our approach is particularly efficient at defining poor outcome risk in Brigham and Women's Hospital (BWH) T2a and American Joint Committee on Cancer (AJCC) T2 cSCCs. This bridges a significant gap in our ability to assess risk among T2a/T2 cSCCs and may be useful in defining patients at highest risk of poor outcome at the time of diagnosis. Early identification of highest-risk patients could signal implementation of more stringent surveillance, rigorous diagnostic work up and identify patients who might best respond to early postoperative adjunctive treatment.
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Affiliation(s)
- Nicolas Coudray
- Applied Bioinformatics Laboratories, New York University School of Medicine, New York, NY, USA
- Department of Cell Biology, New York University School of Medicine, New York, NY, USA
| | - Michelle C. Juarez
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA
| | - Maressa C. Criscito
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA
| | | | - Reason Wilken
- Department of Dermatology, Northwell Health, New York, NY, USA
| | | | - Mary L. Stevenson
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA
| | - Nicole A. Doudican
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA
| | - Ke Yuan
- School of Computing Science, University of Glasgow, Glasgow, Scotland, UK (Ke Yuan)
- School of Cancer Sciences, University of Glasgow, Glasgow, Scotland, UK (Ke Yuan)
- Cancer Research UK Beatson Institute, Glasgow, Scotland, UK (Ke Yuan)
| | - Jamie D. Aquino
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel M. Klufas
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Jeffrey P. North
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Siegrid S. Yu
- Department of Dermatology, University of California, San Francisco, San Francisco, CA, USA
| | - Fadi Murad
- Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily Ruiz
- Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Chrysalyne D. Schmults
- Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Aristotelis Tsirigos
- Applied Bioinformatics Laboratories, New York University School of Medicine, New York, NY, USA
- Department of Pathology, New York University School of Medicine, New York, NY, USA
| | - John A. Carucci
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA
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