{
  "abstract": "Objectives: Distant metastasis (DM) remains a significant challenge in oral squamous cell carcinoma (OSCC) management. This multicenter study aimed to identify risk factors for metachronous isolated DM and evaluate treatment outcomes in Japanese OSCC patients. Materials and methods: We retrospectively analyzed 2166 OSCC patients who underwent curative surgery without preoperative therapy at seven Japanese institutions between January 2001 and December 2018. Risk factors for isolated DM were evaluated using multivariable Cox proportional hazards regression. Survival outcomes were compared among treatment modalities using Cox proportional hazards regression. Results: Isolated DM developed in 129 patients (6.0%), with the lung being the predominant site (86.0%). Multivariable analysis identified four independent predictors of DM development: advanced T classification (T3-4; hazard ratio [HR]: 2.03, 95% confidence interval [CI]: 1.36-3.02), poor differentiation (HR: 2.14, 95% CI: 1.28-3.58), pathological nodal metastasis (pN+; HR: 3.87, 95% CI: 2.29-6.55), and extranodal extension (ENE; HR: 2.84, 95% CI: 1.80-4.46). Among patients with DM, local treatment of metachronous isolated DM was associated with significantly longer overall survival than systemic chemotherapy (adjusted HR: 0.38, 95% CI: 0.18-0.78, P = 0.008) and best supportive care (adjusted HR: 0.15, 95% CI: 0.07-0.30, P < 0.001), with a 3-year survival rate of 46.3%. Conclusion: Advanced T stage, nodal involvement, ENE, and poor differentiation are significant predictors of metachronous isolated DM in OSCC. Local treatment of isolated DM was associated with longer survival in carefully selected patients with limited metastatic disease; prospective studies are needed to determine whether this reflects a treatment effect or patient selection.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan",
    "Clinical and Translational Research Center, Kobe University Hospital, Kobe, Japan",
    "Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Kashihara, Japan",
    "Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, The University of Osaka, Osaka, Japan",
    "Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, The University of Osaka, Osaka, Japan; Department of Oral and Maxillofacial Surgery, Morinomiya Hospital, Osaka, Japan",
    "Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan",
    "Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan",
    "Department of Oral and Maxillofacial Surgery, Oita Red Cross Hospital, Oita, Japan",
    "Department of Oral Surgical Oncology, Hokkaido Cancer Center, Sapporo, Japan"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "name": "Yasumasa Kakei"
    },
    {
      "affs": [
        0
      ],
      "name": "Takumi Hasegawa"
    },
    {
      "affs": [
        1
      ],
      "name": "Takumi Imai"
    },
    {
      "affs": [
        2
      ],
      "name": "Hiroshi Nakamura"
    },
    {
      "affs": [
        2
      ],
      "name": "Nobuhiro Yamakawa"
    },
    {
      "affs": [
        3
      ],
      "name": "Yusuke Yokota"
    },
    {
      "affs": [
        4
      ],
      "name": "Masaya Okura"
    },
    {
      "affs": [
        5
      ],
      "name": "Tomofumi Naruse"
    },
    {
      "affs": [
        6
      ],
      "name": "Hiroshi Kurita"
    },
    {
      "affs": [
        7
      ],
      "name": "Eiji Hirai"
    },
    {
      "affs": [
        8
      ],
      "name": "Shin Rin"
    },
    {
      "affs": [
        8
      ],
      "name": "Michihiro Ueda"
    },
    {
      "affs": [
        0
      ],
      "name": "Masaya Akashi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5f9t26hpathys.bib",
  "cited_by": 0,
  "doi": "10.1016/j.oor.2026.100805",
  "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2772906026000245",
  "id": "5f9t26hpathys",
  "issns": [
    "2772-9060"
  ],
  "landing_url": "https://doi.org/10.1016/j.oor.2026.100805",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC254-282"
    ],
    [
      "openalex",
      "2733|Head and Neck Cancer Studies"
    ]
  ],
  "openalex": "W7223122086",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-30",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/5f9t26hpathys.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:22Z",
      "native_id": "0b2047248fef4b4387ea800e44f18b16",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.oor.2026.100805"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC254-282",
      "subfield": "oncology"
    }
  ],
  "title": "Risk factors and treatment outcomes of metachronous isolated distant metastasis in oral squamous cell carcinoma: A multicenter retrospective cohort study in Japan",
  "title_text": "Risk factors and treatment outcomes of metachronous isolated distant metastasis in oral squamous cell carcinoma: A multicenter retrospective cohort study in Japan",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:43:39Z",
  "url": "https://research.draconitic.com/paper/5f9t26hpathys",
  "venue": "Oral Oncology Reports",
  "versions": []
}