구강 편평세포암종 환자에서 원격 전이와 생존 관련 임상병리학적 위험인자 분석 Statistical Analysis of Clinicopathological Factors Influencing Distant Metastasis in Oral Squamous Cell Carcinoma
pp.99-119
Distant metastasis is an uncommon but critical determinant of prognosis in oral squamous cell carcinoma (OSCC). This study aimed to evaluate clinicopathological risk factors associated with distant metastasis and overall survival (OS) in surgically treated patients with OSCC. A retrospective review was conducted on 116 patients who underwent surgery for oral cancer at Samsung Medical Center between 2018 and 2024. Clinicopathological variables—including depth of invasion (DOI), extranodal extension (ENE), lymphovascular invasion (LVI), perineural invasion (PNI), and worst pattern of invasion (WPI)—were analyzed. Kaplan–Meier survival analysis and Cox proportional hazards regression were used to assess prognostic factors. Distant metastasis occurred in 9.1% of patients and was significantly associated with inferior OS (P < 0.0001). In univariate analysis, LVI, ENE, WPI, and multiple metastatic lymph nodes were significantly associated with poor prognosis. Multivariate analysis identified focal LVI as an independent predictor of OS (HR = 14.23, 95% CI: 1.85–109.67, P = 0.011). Subgroup analysis showed a higher frequency of distant metastasis among patients without neck dissection and those with deeper tumor invasion, although statistical significance was not consistently achieved due to limited events. The lung was the most common site of metastasis, and median post-metastatic survival was 5 months. LVI, ENE, WPI, and nodal burden are significant prognostic factors for OSCC. Focal LVI was independently associated with survival. These findings support the integration of high-risk pathological features into postoperative surveillance and treatment planning.
Ⅰ. INTRODUCTION
Ⅱ. Subjects and Methods
Study Design and Patient Selection
Clinical and Pathological Evaluation
Clinical Outcomes
Statistical Analysis
Ⅲ. Results and Discussion
Baseline Clinicopathological Characteristics
Survival Outcomes and Prognostic Factors
Subgroup Analysis of Factors Associated withDistant Metastasis in Oral Squamous CellCarcinoma
Patterns and Sites of Distant Metastasis
Time to Distant Metastasis and Post-MetastaticSurvival
Logistic Regression Analysis for MetastasisPrediction
AKNOWLEDGEMENTS
REFERENCES
Supplementary Tables
Supplementary Table 1. Clinico-pathological characteristics of patients with and without distant metastasis (Pathology SCC only, n = 80)
Supplementary Table 2. Distribution of distant metastasis sites
Supplementary Figures
Supplementary Figure 1. Kaplan–Meier survival curves according to adjuvant treatment modality (n=99)
Supplementary Figure 2. Kaplan–Meier survival curves based on perineural invasion (PNI) status (n=99)
Supplementary Figure 3. Kaplan–Meier survival curves according to bone invasion status (n=91)
Supplementary Figure 4. Kaplan–Meier survival curves according to surgical margin status (n=94)
Supplementary Figure 5. Kaplan–Meier survival curves based on histologic tumor differentiation (n=74)
Supplementary Figure 6. Kaplan–Meier survival curves according to the presence of worst pattern of invasion (WPI) (n= 80)
Supplementary Figure 7. Kaplan–Meier survival curves based on pathological T stage (pT) (n=91)
Supplementary Figure 8. Kaplan–Meier survival curves according to depth of invasion (DOI) (n=99)
Supplementary Figure 9. Kaplan–Meier survival curves by neck dissection (ND) status (n=99)
Supplementary Figure 10. Kaplan–Meier survival curves by pathological nodal stage (pN) (n=73)
Supplementary Figure 11. Kaplan–Meier survival curves stratified by number of metastatic lymph nodes