Prognosis of oral squamous cell carcinoma patients with level IV/V metastasis: An observational study

Publication date: Available online 29 October 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Takumi Hasegawa, Yasuyuki Shibuya, Daisuke Takeda, Eiji Iwata, Izumi Saito, Yasumasa Kakei, Akiko Sakakibara, Masaya Akashi, Tsutomu Minamikawa, Takahide Komori
PurposeThe objectives of this study were to retrospectively describe the characteristics and outcomes of patients with oral squamous cell carcinoma (OSCC) with level IV/V metastases, and to evaluate the multivariate relationships among potential risk factors for metastasis and prognosis.Materials and MethodsWe evaluated 291 patients (178 men and 113 women; mean age, 65.9 ± 13.5 years). Clinicopathological data, time of development of level IV/V metastases, and clinical course were investigated.ResultsTwenty-three patients (7.9%) developed level IV/V metastases. The 3-year overall survival rates when level IV/V metastasis first developed were 27.3% upon initial treatment, 57.1% when metachronous neck metastasis developed, and 40.0% when the tumor recurred. Oral tongue tumor subsite, high N staging, neck dissection when metachronous neck metastasis developed, as well as recurrence were independent risk factors for level IV/V metastasis.ConclusionWe demonstrate here the multivariate relationships among the risk factors indicated above for level IV/V metastasis and their prognostic significance for patients with OSCC. Oral tongue tumors, high N staging, and neck dissection upon the occurrence of metachronous neck metastasis or recurrence were risk factors for level IV/V metastasis and positive extracapsular spread, presence of multiple lymph metastases, and moderate or poor differentiation were poor prognostic factors.



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