Risk Factors for Distant Metastasis in Patients with Oral Cavity Squamous Cell Carcinoma Undergoing Surgical Treatment

Abstract

Objective: The aim of this study is to investigate the clinical and pathological factors related to distant metastasis in patients with oral cavity squamous cell carcinoma (OCSCC) undergoing surgery. Study Design: A retrospective data review was conducted on patients who underwent primary surgery for OCSCC at the Instituto do Cancer do Estado de São Paulo (ICESP) between 2009 and 2015. Distant metastasis rates were calculated and predictive factors were determined by the Cox proportional-hazards model. Results: There was a total of 274 patients, including 210 (76.6%) men and 64 (23.4%) women, with a mean age of 59.9 ± 10.9 years. The incidence of distant metastasis was 9.6%, with the lung being the most common site. The mean time interval between surgical treatment and the diagnosis of distant metastasis was 12 months (range 2–40 months). In the multivariate analysis, angiolymphatic invasion (HR = 2,87; p = 0.023), contralateral cervical metastasis (HR = 3.3; p = 0,007), tumor thickness >25 mm (HR = 3.50; p = 0.009), and locoregional recurrence (HR = 6.59; p < 0.0001) were the only independent risk factors for distant metastasis. Conclusion: Patients with OCSCC who have contralateral lymph node metastasis, tumors with a thickness >25 mm, angiolymphatic invasion, or locoregional recurrence after surgical treatment have a greater risk of developing distant metastasis.

Características clínicas da metástase do carcinoma de células escamosas oral

“…Em uma revisão retrospectiva dos dados de pacientes submetidos à cirurgia primária no Instituto do Câncer do Estado de São Paulo entre os anos de 2009 e 2015, verificou-se que de um total de 274 pacientes, a incidência de metástase à distância foi de 9,6%, sendo o pulmão o local mais comum. Observou-se na mesma pesquisa que o intervalo médio de tempo entre o tratamento cirúrgico e o diagnóstico de metástase à distância foi de 12 meses e na análise multivariada, invasão angiolinfática, metástase cervical contralateral, espessura tumoral maior que 25mm e recidiva loco-regional foram os únicos fatores de risco independentes para metástase à distância (Aires, Lin, Matos, Kulcsar & Cernea, 2017).…”

Elevated exosomal lysyl oxidase like 2 is a potential biomarker for head and neck squamous cell carcinoma

“…Head and neck squamous cell carcinoma (HNSCC) accounts for over 90% of all head and neck cancers and shows characteristics of distant metastases. The metastases are frequently accompanied by lymph node metastases, and distant metastases without lymph node metastases are rare, implying a requirement for lymph node colonization upon distant metastases . Thus, suppressing lymph node metastasis has been a focus of cancer research and treatment.…”

Distant metastases in newly diagnosed tongue squamous cell carcinoma

“…Distant metastases of OSCC after treatment are common in the lung, bone, liver, brain and other sites (Liu, Bhayani, Kuchta, Galloway, & Fundakowski, ). Data from academic cancer centres and retrospective studies have yielded varying results about the distant metastasis rates at each site, and the population‐based estimates of the prognosis of newly diagnosed OSCC patients with distant metastases are insufficient (Aires, Lin, Matos, Kulcsar, & Cernea, ; Garavello, Ciardo, Spreafico, & Gaini, ; Hasegawa et al, ; Hosni et al, ; Krstevska, Stojkovski, & Zafirova‐Ivanova, ; Sakamoto et al, ; Spector et al, ; Sumioka et al, ; Takahashi et al, ; Takes et al, ; Yao et al, ). A total of 5.7% patients with TSCC, which is the most common type of OSCC, had distant metastases and a lower 5‐year survival rate than patients with other types of OSCC (Osaki, Kimura, Tatemoto, Yamamoto, & Yoneda, ; Young et al, ).…”

“…of newly diagnosed OSCC patients with distant metastases are insufficient (Aires, Lin, Matos, Kulcsar, & Cernea, 2017;Garavello, Ciardo, Spreafico, & Gaini, 2006;Hasegawa et al, 2015;Hosni et al, 2017;Krstevska, Stojkovski, & Zafirova-Ivanova, 2010;Sakamoto et al, 2016;Spector et al, 2012;Sumioka et al, 2013;Takahashi et al, 2014;Takes et al, 2012;Yao et al, 2012). A total of 5.7% patients with TSCC, which is the most common type of OSCC, had distant metastases and a lower 5-year survival rate than patients with other types of OSCC (Osaki, Kimura, Tatemoto, Yamamoto, & Yoneda, 2000;Young et al, 2015).…”