对口咽鳞状细胞癌（OPSCC）行手术治疗后的区域转移和复发模式进行调查和描述。回顾性研究，收入2006年至2021年期间在三级转诊中心诊断为OPSCC的患者。只纳入接受包括颈部淋巴清扫术在内的手术治疗的患者。排除未知人乳头状瘤病毒（HPV）病毒感染情况、既往头颈部癌症、远处转移或同步头颈部癌症的患者。共纳入了928名患者，其中89%为男性，平均年龄为58.6岁（范围：25.2-87.5），874例（94%）患者为HPV阳性，513例（55.3％）患者患有扁桃体癌。在cN阳性患者中，出现转移的最常见的区域是II级（85.2%）、III级（33.3%）和IV级（9.4%）。在cN0患者中，转移仅观察到在II级（16.2%）和III级（9.2%）。48名患者（5.2%）出现淋巴结复发，中位时间为1.0年（四分位间距：0.6-2.0）。淋巴结复发发生率在HPV阳性和HPV阴性患者之间相似（5.0% vs. 7.4%，p = 0.44）。区域复发的主要级别为同侧II级（45.8%）、对侧II级（43.8%）和同侧V级（25.0%）。多变量分析显示，pN是区域复发的显著预测因子（p = 0.02）。在HPV阳性和HPV阴性OPSCC患者中，区域转移和复发的分布没有差异。我们的研究结果与已确立的认识一致，即区域转移主要在同侧II-IV级出现。此外，数据支持在cN0患者中选择性地进行同侧IIa和III级的预防性颈部淋巴清扫，排除IIb级。区域复发与pN状态显著相关。版权所有 © 2023，由Elsevier Ltd出版。

To investigate and describe the patterns of regional metastases and recurrences after surgical treatment of oropharyngeal squamous cell cancer (OPSCC).Retrospective study of patients diagnosed with OPSCC from 2006 to 2021 at a tertiary referral center. Only patients treated with surgery including a neck dissection were included. Patients with unknown human papillomavirus (HPV) status, prior head and neck cancer, distant metastases, or synchronous head and neck cancer were excluded.A total of 928 patients were included. 89% were males, the average age was 58.6 years (range: 25.2-87.5), 874 (94%) were HPV(+), and 513 (55.3%) had a tonsil cancer. Among cN + patients, the most commonly involved levels at presentation were level II (85.2%), level III (33.3%), and level IV (9.4%). In cN0 patients, metastases were only observed in level II (16.2%) and level III (9.2%). Nodal recurrence occurred in 48 (5.2%) patients after a median time of 1.0 years (interquartile range: 0.6-2.0). Nodal recurrence incidence was similar in HPV(+) and HPV(-) patients (5.0% vs. 7.4%, p = 0.44). The most common levels for regional recurrence were ipsilateral level II (45.8%), contralateral level II (43.8%), and ipsilateral level V (25.0%). Multivariable analysis revealed that pN was a significant predictor for regional recurrence (p = 0.02).There is no difference in the distribution of regional metastases and recurrences in HPV(+) and HPV(-) OPSCC patients. Our findings align with the established understanding that regional metastases predominantly manifest in the ipsilateral level II-IV at presentation. Moreover, the data support the clinical recommendation to restrict elective neck dissection in cN0 patients to ipsilateral levels IIa and III, excluding level IIb. Regional recurrence is significantly associated with pN status.Copyright © 2023. Published by Elsevier Ltd.