Development and Validation of a Classifier for Prediction of Distant Metastasis in Nasopharyngeal Carcinoma at Initial Staging

we sought to improve the prediction of DM in NPC patients by developing a novel combined classifier to stratified patients into high-risk and low-risk groups with significant differences in 5-year survival. To our best of knowledge, our study is the first to integrate intratumor heterogeneity with EBV DNA for predicting DM in NPC patients, and found the combined classifier achieved superior prognostic performance than either the radiomic signatures or the clinical variables alone, which with a higher AUC, sensitivity, and specificity improvement.