Oral cavity carcinoma and distant metastasis: Relationship between number of foci and affected organs with prognosis

• Grant number: 24/08329-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: August 01, 2024
• End date: April 30, 2025
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Leandro Luongo de Matos
• Grantee: Pedro Burlacchini Sanches Marinho
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Oral cavity carcinoma is a common neoplasm with a high mortality rate, with oral cavity squamous cell carcinoma being its most common histological subtype (OSCC). Its treatment consists of oncological resection, associated with neck dissection and adjuvant therapy, when indicated, but especially in advanced stages. Distant metastases (DM) in OSCC, although uncommon, are associated with a worse prognosis. The risk factors for DM are primary tumor (pT3-4), tumor thickness > 25mm, nodal involvement (pN+), histological grade (G3) and lymphovascular invasion. In clinical practice, oligometastatic disease, namely, low-volume disease, has a different clinical course from patients with rapidly progressive disease. Thus, the characterization of DM according to the number of foci and affected organs is crucial in a context in which increasingly individualized treatment is the key to a better prognosis. However, the current classification system of the American Joint Committee on Cancer (AJCC) does not include such a distinction between metastatic stages, with only undetermined metastases (Mx), absent distant metastases (M0) and present distant metastases (M1). Therefore, in this study, we propose the stratification of patients with distant metastases into three different groups; (a) Only one metastatic focus in a single organ; (b) More than one metastatic focus in a single organ; (c) More than one affected organ, with the aim of relating these groups to the overall survival rates and detailing the description of oncological outcomes in each of them.