Elective neck dissection (END) is recommended for the management of patients with oral squamous cell carcinoma (OSCC) because of the risk of occult metastasis (OM). We hypothesized that some factors predict poor prognosis regardless of a cN0 END. This study aimed to investigate the predictors of OM and prognostic factors in patients with cN0 OSCC who underwent supraomohyoid neck dissection (SOHND). A retrospective cohort study design was created and implemented. The primary predictive variables in this study were OM and risk factors for poor prognosis after SOHND. A Cox proportional hazard model was used to adjust for the effects of potential confounders on the risk factors for poor prognoses. Among 86 patients with OSCC, OMs were observed in 9 (10.5%). The neutrophil-to-lymphocyte ratio (NLR) and vascular invasion are good markers for detecting OM. A Cox multivariable analysis identified two independent predictors of overall survival: pathologic node (pN) and laterality of END. An independent predictive factor for disease-free survival, the surgical margin, was also identified in this study. According to the pN classification, pN1 patients had a worse survival rate than pN2 patients. Therefore, in the case of pN1, regardless of being cN0, additional adjuvant therapy may be necessary.

To determine the intracellular behavior of p62, a marker of selective autophagy, in oral potentially malignant disorders (OPMDs). This retrospective study includes 70 patients who underwent biopsy or surgical resection and were definitively diagnosed with OPMDs. Immunohistochemical staining for p62, XPO1, p53, and ki67 was performed on all samples and positive cell occupancy was calculated. We statistically investigated the correlation between protein expression in OPMDs and the association between malignant transformation, clinicopathological characteristics, and occupancy. ki67 expression was negatively correlated with p62 expression in the nucleus (p < 0.01) and positively correlated with p62 expression in the cytoplasm (p < 0.01). For malignant transformation, the expression of p62 in the nucleus (p = 0.03) was significantly lower in malignant transformation cases, whereas the expression of p62 in the cytoplasm (p = 0.03) and the aggregation expression (p < 0.01) were significantly higher. Our results suggest that the function of p62 is altered by its subcellular localization. In addition, defects in selective autophagy occur in cases of malignant transformation, suggesting that p62 is a potential biomarker of the risk of malignant transformation of OPMDs.

Factors influencing oral squamous cell carcinoma (OSCC) prognosis include local and systemic factors, such as nutritional status. Skeletal muscle mass (SMM) loss is a poor prognostic factor not only in elderly patients, but also in cancer patients. We investigated SMM index (SMI), surgical site infection (SSI), and prognosis of patients who underwent resection and free flap reconstructive surgery (FFRS). Ninety-two patients (59 males and 33 females) underwent FFRS between 2013 and 2021. SMM at L3 was measured using preoperative computed tomography. The optimal cutoff for SMM was 49.29 cm2/m2 in males (AUC 0.639) and 41.08 cm2/m2 in females for overall survival (OS) (AUC 0.535). Patients were classified into low and high SMI groups and OS was statistically evaluated. Sixty-three (68.5%) and 29 (31.5 %) patients had low and high SMI, respectively. SSI occurred in 11 (12.0%) patients, and wound dehiscence and delayed wound healing were observed in 22 (23.9%). SSI showed no significant difference between low- and high-SMI groups. In contrast, OS showed significance by age, pathological N (pN), extra nodal extension (ENE), and SMI (high of 89.7%, low of 61.8%). Univariate analyses demonstrated significant associations between OS and age (≥65 vs. <65), SMI (low vs. high), pN (present vs. none), ENE (present vs. none), and albumin (<4.0 vs. ≥4.0). Cox multivariate analysis included SMI (low vs. high; HR: 5.898, 95% CI: 1.691-20.565; P=0.005) and ENE (present vs. none; HR: 9.843, 95% CI: 3.781-25.629; P<0.001). SMI and ENE were independent predictive factors of OS in patients undergoing FFRS for OSCC.