Multicenter retrospective study of the prognosis and treatment outcomes of Japanese oral squamous cell carcinoma patients with level IV/V metastasis

Abstract

Background: The purpose of this study was to retrospectively describe the characteristics and outcomes of patients with oral squamous cell carcinoma and level IV/V metastasis and to compare patients who underwent no postoperative therapy with those who underwent postoperative radiotherapy (RT) and concomitant chemoradiotherapy (CCRT). Methods: We evaluated 669 patients. Clinicopathological data, postoperative therapy, and clinical course were investigated. Results: Sixty-one patients (9.1%) developed level IV/V metastasis. The 3-year cumulative overall survival rates of patients with and without level IV/V metastasis were 47.3% and 64.3%, respectively. Tongue tumors, pN2 or N3 classification, and moderate or poor differentiation were significantly associated with the development of level IV/V metastasis. The surgery+RT/CCRT group was associated with better 3-year cumulative disease-specific survival and overall survival rates than the surgery only group. Conclusion: Adjuvant therapy (RT alone or CCRT) after surgery is recommended for patients with level IV/V metastasis. K E Y W O R D Slevel IV/V metastasis, lymph node metastasis, neck level, oral cancer, risk factor

Adding Concomitant Chemotherapy to Postoperative Radiotherapy in Oral Cavity Carcinoma with Minor Risk Factors: Systematic Review of the Literature and Meta-Analysis

“…Jones [ 125 ] and Liao [ 126 ] showed that lower levels of lymph node involvement were associated with poor prognosis and higher risk of distant metastasis. In the study by Hasegawa and colleagues [ 19 ], multivariate analysis demonstrated significant relationships between level IV/V metastasis and prognosis in OCC patients. Tongue tumors, pN2 or pN3, and moderate or poor differentiation were significantly associated with the development of level IV/V metastases.…”

“…Only studies including oncological outcomes (overall survival, disease-free survival, and local recurrence-free survival) for patients affected by oral cavity carcinoma (OCC) treated with post-operative chemoradiotherapy who showed the presence of minor risk factors were analyzed. Criteria for exclusion are reported in the Supplementary Materials Table S2 [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ,…”

Extranodal Extension in Bilateral Cervical Metastases: A predictor of Undesirable Survival Outcomes despite Aggressive Salvage Treatment in Oral Cancer Patients

“…It is plausible that OCSCCs in different oral subsites grow, invade the surrounding organs, and metastasize to regional lymph nodes in different ways 35 - 36 . In our study, the retromolar trigone 4, 3.1%), lower gingiva (10, 7.8%) and bucca (8, 6.3%) were found to be associated with much lower DFS.…”