Background: Epithelial-to-mesenchymal transition (EMT) program plays a critical role in cancer. Thus, we attempted to generate a risk score system according to the expression pattern of different EMT hallmark genes in head and neck squamous-cell carcinoma (HNSC).
Methods: Differentially expressed EMT hallmark genes were screened to generate a risk score (RS) on TCGA HNSC dataset. The relative prognostic value of the RS  compared to clinicopathological characteristics was explored using multivariable Cox analysis. Functional enrichment analysis was performed to reveal the biological characteristics. An external dataset was applied to validate the prognostic value of the RS .
Results: Nine genes constituted the EMT hallmark gene-based RS , which is significantly associated with poor prognosis and could successfully divide patients with HNSC into high- and low-risk groups. The RS  was also an independent prognostic indicator compared to routine clinical factors.
Conclusion: We proposed and validated a nine-EMT hallmark gene-based risk score system in HNSC.
Keywords: head and neck squamous-cell carcinoma, epithelial-to-mesenchymal transition, EMT, risk score system, angiogenesis