Current Concepts in Oral Cancer Metastasis and the Possible Role of Desmoglein 3 in Lymph Node Metastasis

Oral cancer (OC) remains the most common cancer affecting the head-and-neck region. In spite of advancements in both diagnostic and management techniques, its incidence and associated mortality have risen significantly. Metastasis in OC is a multifaceted process involving the separation of tumour cells, their proliferation and subsequent invasion through the lymphatic or hematopoietic systems. Distant metastasis plays a pivotal role in the treatment as well as in the prognosis of OC patients. Lymph node metastasis (LNM) is a significant adverse prognostic factor in oral squamous cell carcinoma (OSCC). The four stages in LNM in OSCC are ‘Preparation, Unleashing, Migration and Planting’ principle. Furthermore, the role of desmosomal cadherins, namely desmoglein 3 (Dsg3), may play a role and is known to contribute to the progression of cancer, as its overexpression significantly increases the spread of cells and cell migration. This review highlights the current concepts in OC metastasis and the role of Dsg3 in LNM and its possible role as a marker for metastatic lymph node assessment in OSCC.