Clinical characteristics and local recurrence risk in patients with multiple actinic keratoses - a retrospective clinical data analysis

Sep 22, 2026

Retrospective clinical analysis evaluates local recurrence risk in 148 patients with multiple actinic keratoses (AKs), focusing on host-, lesion-, and treatment-related factors and building a Cox regression model for individualized prediction. Kaplan–Meier estimates cumulative recurrence at 12, 24, and 36 months, while Cox modeling identifies independent predictors and tests interaction between lesion count and treatment response. Higher lesion count and incomplete treatment response predict recurrence, whereas immunosuppression and regular sunscreen use are not significant. Model performance is assessed by calibration, Harrell’s C-index, Brier score, and a nomogram for risk estimation.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Objective

Methods

Results

Conclusion

Introduction

TYPE Original Research PUBLISHED 11 February 2026 DOI 10.3389/fonc.2026.1770341 OPEN ACCESS EDITED BY Hao Chang, University of Wisconsin-Madison, United States REVIEWED BY Tianshun Zhang, University of Minnesota Twin Cities, United States Stefano Bighetti, University of Brescia, Italy *CORRESPONDENCE Jianjian Zhu [lidocute@163.com](lidocute@163.com)[ ](lidocute@163.com)Miao Wan [970628271@qq.com](970628271@qq.com) RECEIVED 18 December 2025 REVISED 09 January 2026 ACCEPTED 12 January 2026 PUBLISHED 11 February 2026 CITATION Liu Z, Tang Y, He P, Long J, Chen Z, Wan M and Zhu J (2026) Clinical characteristics and local recurrence risk in patients with multiple actinic keratoses: a retrospective clinical data analysis. Front. Oncol. 16:1770341 . doi: 10.3389/fonc.2026.1770341 COPYRIGHT © 2026 Liu, Tang, He, Long, Chen, Wan and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Clinical characteristics and local recurrence risk inpatients with multiple actinickeratoses: a retrospective clinical data analysis Zhaogui Liu 1, Yaping Tang 2, Ping He 1, Jian Long 1, Zhang Chen 1, Miao Wan 1* and Jianjian Zhu 1* 1 Department of Dermatology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, Hunan, China, 2 Department of Dermatology, The Tenth Afﬁliated Hospital of Southern Medical University (Dongguan City People's Hospital), Dongguan, China Objective: To evaluate the risk of local recurrence in patients with multiple actinic keratoses (AKs), to analyze the inﬂuence of host-, lesion-, and treatmentrelated factors, and to develop and validate a Cox regression model for predicting recurrence risk. Methods: This retrospective study enrolled 148 patients with multiple AKs during January 2019-February 2022 . Baseline characteristics, treatment modalities, and follow-up outcomes were collected. The Kaplan-Meier method was used to estimate cumulative recurrence rates. Cox regression analyses were performed to identify independent risk factors. The interaction effect between lesion count and treatment response was further assessed. A multivariate Cox predictive model was constructed, and its performance was validated using the 24-month calibration curve, Harrell ’s C-index, and Brier score. A nomogram was developed for individualized risk prediction. Results: The cumulative recurrence rates at 12, 24, and 36 months were 22 .3%, 35. 6%, and 44 .7%, respectively. Multivariate analysis identiﬁed higher lesion count (11-20: HR = 2.39; > 20: HR = 2.96) and incomplete treatment response (HR = 2.43) as independent risk factors. Immunosuppression and regular sunscreen use were not signiﬁcant. Although visual analysis suggested elevated risk with more lesions and incomplete response, their interaction term was not statistically signiﬁcant. The model demonstrated moderate discrimination (C-index = 0. 630) and good calibration (Brier score = 0 . 176) . The nomogram enabled individualized risk estimation. Conclusion: Lesion burden and incomplete treatment response signiﬁcantly predict recurrence in multiple AKs patients. The developed Cox model and nomogram offer a clinically useful tool for identifying high-risk individuals and optimizing management strategies. KEYWORDS actinic keratosis, Cox regression, nomogram, prediction model, recurrence Frontiers in Oncology 01 [frontiersin.org](frontiersin.org) 1 Introduction Actinic keratosis (AK) is a chronic cutaneous photodamage condition induced by long-term ultravi

FAQs

What was the study objective regarding multiple actinic keratoses?

To evaluate local recurrence risk, analyze the influence of host-, lesion-, and treatment-related factors, and develop and validate a Cox regression model to predict recurrence risk.

How many patients were included and what follow-up duration was analyzed?

The retrospective study included 148 patients with multiple AKs, with outcomes summarized for recurrence rates at 12, 24, and 36 months.

Which factors were found to independently predict recurrence?

Higher lesion count and incomplete treatment response were identified as independent risk factors for local recurrence, while immunosuppression and regular sunscreen use were not significant.

Sep 22, 2026

Upload by Olivia Brown