Epithelial-Mesenchymal Interactions in Oral Cancer Metastasis

Squamous cell carcinoma of the oral cavity is one of the most prevalent tumors of the head and neck region. Despite an ever-expanding fund of knowledge regarding the etiology and pathophysiology of malignant neoplasms, oral squamous cell carcinoma (OSCC) continues to be a disfiguring and deadly disease. For patients with squamous cell carcinoma of the oral cavity or oropharynx, the 5-year survival is a dismal 56%, which has remained relatively unchanged in recent years (Davis et al., 2010). This poor prognosis reflects the fact that most patients present with advanced-stage disease, often making a complete cure a seemingly unattainable goal. In fact, just 46% of oral cavity and 16% of oropharyngeal cancers are diagnosed when there is only local disease (Davis et al., 2010). Despite recent improvements in therapeutic approaches, treatment failure takes the form of local and regional recurrences, but as disease control in these areas improves OSCC treatment failures more commonly occur as distant metastasis. Metastatic behavior is critical to survival, since patients with oral carcinomas that have distant disease have a five-year survival rate that is three times less than that of patients with spread to lymph nodes (Singh and Shah, 2003).