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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.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & 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 \nUniversity of Wisconsin-Madison, United States  \nREVIEWED BY  \nTianshun Zhang,  \nUniversity of Minnesota Twin Cities, United States  \nStefano Bighetti,  \nUniversity of Brescia, Italy  \n*CORRESPONDENCE  \nJianjian Zhu  \n [lidocute@163.com](lidocute@163.com)[ ](lidocute@163.com)Miao Wan  \n [970628271@qq.com](970628271@qq.com)  \nRECEIVED 18 December 2025  \nREVISED 09 January 2026  \nACCEPTED 12 January 2026  \nPUBLISHED 11 February 2026  \nCITATION  \nLiu Z, Tang Y, He P, Long J, Chen Z, Wan M  \nand Zhu J (2026) Clinical characteristics and local recurrence risk in patients with multiple actinic keratoses:  \na retrospective clinical data analysis.  \nFront. Oncol. 16:1770341 .  \ndoi: 10.3389/fonc.2026.1770341  \nCOPYRIGHT  \n© 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.  \nClinical characteristics and local recurrence risk inpatients with multiple actinickeratoses: a retrospective clinical data analysis  \nZhaogui Liu 1, Yaping Tang 2, Ping He 1, Jian Long 1, Zhang Chen 1, Miao Wan 1* and Jianjian Zhu 1*  \n1 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  \nObjective: 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.  \nMethods: 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.  \nResults: 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.  \nConclusion: 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.  \nKEYWORDS  \nactinic keratosis, Cox regression, nomogram, prediction model, recurrence  \nFrontiers in Oncology 01 [frontiersin.org](frontiersin.org)  \n1 Introduction  \nActinic keratosis (AK) is a chronic cutaneous photodamage condition induced by long-term ultravi","cbCaijC7S0Xp6LmR","https://ap.wps.com/l/cbCaijC7S0Xp6LmR","pdf",1808879,"English","# Objective\n# Methods\n# Results\n# Conclusion\n# Introduction","[{\"question\":\"What was the study objective regarding multiple actinic keratoses?\",\"answer\":\"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.\"},{\"question\":\"How many patients were included and what follow-up duration was analyzed?\",\"answer\":\"The retrospective study included 148 patients with multiple AKs, with outcomes summarized for recurrence rates at 12, 24, and 36 months.\"},{\"question\":\"Which factors were found to independently predict recurrence?\",\"answer\":\"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.\"}]","Clinical characteristics and local recurrence risk in patients with multiple actinic keratoses - a retrospective clinical data analysis | PDF",1790055462,25]