手术干预后的局部和区域复发是癌症管理中的一个重要问题。癌症发生的多阶段理论精确地将肿瘤周围组织中存在的组织学正常但突变的前恶性病变（肿瘤场癌化）作为癌症复发的重要原因之一。多阶段癌症中组织动力学、癌症发生和癌症复发之间的关系尚不得而知。本研究通过结合Moran和分支过程构建了一个癌症发生和复发的计算模型，在该模型中，细胞需要3个或更多的突变才能变为恶性。此外，该模型还包括空间结构设置，以解释向恶性转化的细胞在位置相对性方面的周转。该模型由无突变的正常细胞人群组成，几个具有不同数量突变的前恶性细胞人群和一个恶性细胞人群。该模型计算癌症检测和手术消除恶性细胞但保留前恶性细胞的阶段，然后估计恶性细胞重新出现的时间。通过分析手术时的前恶性细胞类型，我们报告了导致不同癌症发生模式和有利于缩短癌症复发的细胞情况。此外，该模型适合于27种不同癌症类型的8957名患者的无病临床数据; 通过此拟合，我们估计了每种癌症类型的细胞更新速率、前恶性细胞的相对适应性、癌细胞的生长速度和死亡率。我们的研究为如何确定可能有更短复发的患者以及治疗干预目标提供了见解。版权所有© 2023 Abubakar, Takaki和Haeno。

Local and regional recurrence after surgical intervention is a significant problem in cancer management. The multistage theory of carcinogenesis precisely places the presence of histologically normal but mutated premalignant lesions surrounding the tumor - field cancerization, as a significant cause of cancer recurrence. The relationship between tissue dynamics, cancer initiation and cancer recurrence in multistage carcinogenesis is not well known.This study constructs a computational model for cancer initiation and recurrence by combining the Moran and branching processes in which cells requires 3 or more mutations to become malignant. In addition, a spatial structure-setting is included in the model to account for positional relativity in cell turnover towards malignant transformation. The model consists of a population of normal cells with no mutation; several populations of premalignant cells with varying number of mutations and a population of malignant cells. The model computes a stage of cancer detection and surgery to eliminate malignant cells but spares premalignant cells and then estimates the time for malignant cells to re-emerge.We report the cellular conditions that give rise to different patterns of cancer initiation and the conditions favoring a shorter cancer recurrence by analyzing premalignant cell types at the time of surgery. In addition, the model is fitted to disease-free clinical data of 8,957 patients in 27 different cancer types; From this fitting, we estimate the turnover rate per month, relative fitness of premalignant cells, growth rate and death rate of cancer cells in each cancer type.Our study provides insights into how to identify patients who are likely to have a shorter recurrence and where to target the therapeutic intervention.Copyright © 2023 Abubakar, Takaki and Haeno.