Tumour Spread and Metastasis

Squamous cell carcinomas may spread directly to contiguous structures, as well as via lymphatic and blood vessels, giving rise to regional lymph node and distant metastases, or metastases along the nerves. The behaviour and spread of SCCs are affected by various factors, the most important being the site of the primary tumour. This has been attributed to the rich vascular and lymphatic network in certain areas, such as the base of the tongue, where metastatic rates are significantly higher than for similar-sized tumours on the oral tongue. Similarly, poorly vascularised areas, such as the glottis, are associated with a lower rate of metastases [106].

Other factors important for the spread and behaviour of SCCs include the size and the differentiation of the tumour, as well as poorly defined factors of the host, i.e. the immune status and genetic susceptibility [130].

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