{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T02:50:59Z","timestamp":1781837459188,"version":"3.54.5"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The prognostic implications of regional lymph node metastases at the initiation of immune checkpoint inhibitor (ICI) therapy in oral cavity squamous cell carcinoma (OCSCC) are not well defined. This study evaluated whether the presence of metastatic cervical lymph nodes at the start of pembrolizumab therapy was associated with progression\u2010free or overall survival among patients with recurrent or metastatic (R\/M) OCSCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted at a tertiary academic medical center including patients with R\/M OCSCC who initiated pembrolizumab between May 2016 and May 2022. Patients receiving fewer than three cycles were excluded. The presence of metastatic lymph node(s) at ICI initiation was analyzed as a dichotomous variable. The primary outcome was 6\u2010month progression\u2010free survival (PFS), and the secondary outcome was 2\u2010year overall survival (OS). Disease progression was determined using RECIST\u2010based radiographic criteria. Cox proportional hazards models adjusted for age, PD\u2010L1 status, presence of distant metastases, and receipt of concurrent systemic therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010five patients met inclusion criteria; all received pembrolizumab for R\/M disease. Twelve patients (27%) had metastatic cervical lymph nodes at ICI initiation. On univariate analysis, nodal metastasis was associated with poorer 6\u2010month PFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024). After adjustment for age, PD\u2010L1 status, distant metastases, and concurrent systemic therapy, cervical nodal metastasis remained independently associated with inferior PFS (HR 5.12; 95% CI 1.30\u201320.2;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Presence of metastatic cervical lymph nodes at the start of pembrolizumab therapy was associated with reduced 6\u2010month progression\u2010free survival, suggesting regional disease burden may predict limited ICI benefit in R\/M OCSCC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70362","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T01:59:47Z","timestamp":1781834387000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metastatic Lymph Node Status Is Associated With Progression\u2010Free Survival in Oral Cavity Squamous Cell Carcinoma Treated With Pembrolizumab"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5658-6125","authenticated-orcid":false,"given":"Angeline A.","family":"Truong","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"},{"name":"Department of Microbiology and Immunology University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savinnie","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minna K. I.","family":"Apostolova","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4111-9975","authenticated-orcid":false,"given":"Rex H.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5758-8202","authenticated-orcid":false,"given":"Hyunseok","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8121-3726","authenticated-orcid":false,"given":"Ivan H.","family":"El\u2010Sayed","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan R.","family":"George","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4296-8944","authenticated-orcid":false,"given":"Chase M.","family":"Heaton","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"},{"name":"ENT Section, Department of Surgery San Francisco VA Medical Center  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilya","family":"Likhterov","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Jue","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew H.","family":"Spitzer","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0306-6147","authenticated-orcid":false,"given":"Patrick K.","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain P.","family":"Algazi","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8180-4542","authenticated-orcid":false,"given":"Katherine 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