Risk factors for distant metastasis in oral cancer and a strategy preoperative detection

Distant metastasis (DM) from oral carcinoma is usually defined as dissemination of the disease to organs or tissues below the level of the clavicles (1). DM plays a critical role in the management and prognosis of oral squamous cell carcinoma (OSCC). Specifically, overall survival dramatically decreases in cases where distant dissemination is evidenced at presentation or during follow-up (2). With regard to DM from oral cancer, the base of the tongue is the most commonly affected primary site followed by anterior tongue, floor of the mouth, buccal mucosa, and maxilla. The lung is the organ most frequently involved, followed by bone, skin, liver and brain. According to several reports, the incidence of DM at presentation ranges between approximately 1–3% (3,4). However, this value could increase up to 15% during follow-up. Hence, the creation of an accurate protocol based on the assessment of risk factors could be extremely Original Article