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This study analyzed the pattern and predictors of metachronous DMs (MDMs) over time in a large OSCC cohort treated with curative intent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A total of 1,122 patients with primary OSCC were treated at the University Medical Center Hamburg-Eppendorf between 2009 and 2019. After excluding patients with synchronous metastases or palliative treatment, 1,040 patients remained for analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of these, 93 patients (8.94%) developed MDMs. The lungs were the most frequent site (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200964), followed by bone (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200926), thoracic lymph nodes (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919), and liver (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200917). The estimated mean time to MDM was approximately 430 days. In patients with late-onset metastasis (\u2265\u200924 months), the lung was most often the sole site involved. Multiple metastatic sites were observed in 40.86% of cases. Cox regression analysis identified several independent factors associated with early metachronous dissemination (\u2264\u200912 months after diagnosis): pN2c nodal status (HR 10.778, 95% CI 1.123\u2013103.405,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039), age\u2009&lt;\u200960 years (HR 3.626, 95% CI 1.048\u201312.547,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042), and treatment with surgery plus adjuvant radiochemotherapy (HR 20.025, 95% CI 1.954\u2013205.232,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The occurrence of MDMs was observed in around 10% of OSCC patients. Early metachronous dissemination was associated with pN2c, age\u2009&lt;\u200960 years and combination therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>These findings support a time- and pattern-dependent model of distant dissemination in OSCC and may inform risk-adapted surveillance and treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-026-07057-6","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T07:25:49Z","timestamp":1786519549000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns and characteristics of metachronous distant metastases in patients with oral squamous cell carcinoma \u2013 A cohort analysis"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3920-7119","authenticated-orcid":false,"given":"Jakob C.","family":"Roehl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Smeets","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Kristin","family":"Struckmeier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"7057_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I et al (2024) Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. 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