[Metastasis in oral squamous cell carcinoma].

A precise evaluation of the presence of metastasis is mandatory in the management of head and neck malignancies. Squamous cell carcinoma is the most common malignant tumor of the oral cavity, representing slightly more than 90% of all oral malignancies. The present study included 330 consecutive patients with oral squamous cell carcinoma seen at the Oral and Maxillofacial Surgery Division of the Department of Dentistry, Veterans General Hospital-Taipei from June 1975 to December 1990. Among these cases, the tongue (31.2%) was the most frequently involved site. According to AJCC staging system, 37.3% of the patients were at stage IV, the highest among stages of patients. The overall incidence of regional lymph node metastasis was 49.4%. The incidence of regional lymph node metastasis was significantly correlated with the location of the primary tumor, especially the low metastatic rate of palate and lip carcinoma (p less than 0.05). Distant metastases were detected in 14 (4.2%) cases. The rate of distant metastasis increased with the advance of staging (6.2% for stage III and IV, p less than 0.05). The lungs were the most common sites of distant metastasis. Due to the poor awareness and socio-economic condition of the patients, a majority of them presented with advanced diseases. The distant metastasis rate was low since all the patients were not kept followed up till death, nor was any autopsy study carried out.