Lymph node metastasis pattern in recurrent and ipsilateral second primary oral squamous cell carcinoma

Area of Science:

• Oncology
• Head and Neck Surgery
• Cancer Metastasis Research

Background:

• Oral squamous cell carcinoma (OSCC) recurrence and second primary tumors (SPT) present unique clinical challenges.
• Understanding metastasis patterns in recurrent OSCC and SPT is crucial for effective management.

Purpose of the Study:

• To analyze lymph node metastasis patterns in patients with recurrent OSCC or ipsilateral SPT.
• To identify risk factors associated with metastasis in these patient groups.
• To inform clinical diagnosis and treatment strategies for recurrent and secondary oral cancers.

Main Methods:

• Retrospective analysis of patients with recurrent OSCC or ipsilateral SPT undergoing radical surgery (January 2017-March 2023).
• Collection and review of comprehensive clinical and pathological data.
• Multivariate logistic regression to identify risk factors for lymph node metastasis.

Main Results:

• Recurrent/SPT showed a significantly higher lymph node metastasis rate (42.2%) compared to primary OSCC (22.9%).
• Metastasis patterns differed: primary OSCC favored levels I-III, while recurrent/SPT commonly involved ipsilateral level V and contralateral level I.
• Poor tumor differentiation and T2 stage were significant risk factors for lymph node metastasis in both primary and recurrent/SPT settings.

Conclusions:

• Recurrent and ipsilateral SPT have an increased propensity for lymph node metastasis, particularly to specific neck regions (ipsilateral level V, contralateral level I).
• These distinct metastasis patterns in recurrent/SPT correlate with a significantly poorer prognosis.
• Findings emphasize the need for tailored surveillance and management approaches for patients with recurrent or secondary oral cancers.