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Objective This study aimed to determine the impact or survival of low skeletal muscle mass (SMM) among patients with oral squamous cell carcinoma (OSCC) undergoing primary surgery. Design This study was a retrospective cohort study. Setting Oral squamous cell carcinoma patients treated at our referral centre from April 2005 to March 2014 were examined. Participants The cohort comprised 276 patients with OSCC undergoing primary surgery. Main outcome measures Estimated SMM was measured by calculating the cervical skeletal muscle mass from a CT scan of the head and neck. The 5‐year overall survival (OS) and disease‐specific survival (DSS) were analysed using a multivariable Cox regression model. Results There were 276 patients with a male‐to‐female ratio of 12:1. A low SMM (<47.5 cm2/m2) was associated with worse survival. After adjustment for other factors, the result remained robust for OS (hazard ratio [HR] 1.74, 95% confidence interval [CI] 1.14‐2.67) and disease‐specific survival (HR 1.67, 95% CI 1.04‐2.67). In the subgroup analysis, worse OS and DSS were particularly noted in male patients (HR = 1.90, 95% CI 1.22‐2.97; HR = 1.91, 95% CI 1.27‐3.19) and in those younger than 60 years of age (HR = 1.91, 95% CI 1.14‐3.22; HR = 2.12, 95% CI 1.23‐3.64) with low SMM. Conclusions Low SMM was a significant independent factor that was associated with lower survival in patients who have oral cavity cancers and are undergoing primary surgery. Preoperative CT scans of the head and neck could be utilised to evaluate SMM, predict treatment outcomes and facilitate nutrition management.

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MicroRNAs (miRs) are a class of small endogenous non-coding RNAs of ~21–24 nucleotides in length. Previous studies have indicated that miR-196b has either an oncogenic or tumor-suppressive function in various types of cancer. However, the biological role of miR-196b in oral squamous cell carcinoma (OSCC) remains unclear. In the present study, the expression levels of miR-196b were examined in oral cancer tissues and corresponding adjacent normal tissues from 69 OSCC patients using stem-loop reverse transcription-quantitative polymerase chain reaction. The results indicated that miR-196b was significantly overexpressed in OSCC tissues compared with the corresponding adjacent normal tissue samples (64 of 69, 92.7%, P<0.001). Analysis of the methylation status of the miR-196b gene indicated more frequent hypomethylation of the CpG islands located upstream of the miR-196b gene in the OSCC tissues than in the adjacent normal tissues (32 of 69, 46.3%), and the methylation status of miR-196b correlated inversely with its expression levels. Furthermore, the unmethylated status of the miR-196b promoter correlated with poor disease-specific survival in OSCC patients (P=0.035). Functional analysis revealed that ectopic miR-196b expression promoted oral cancer cell migration and invasion abilities, and that silencing of miR-196b could abrogate in vitro migration and invasion of oral cancer cells. Collectively, the present findings indicate that the epigenetic regulation of miR-196b expression plays a crucial role in modulating cell migration and invasion during OSCC progression, and thus may serve as a potential prognosis marker or therapeutic target for OSCC.