
This retrospective cohort study, using the National Cancer Database, assessed the risk of occult invasive disease in patients with biopsy-proven carcinoma in situ (CIS) of the oral cavity. Among 1,856 patients, 28.0% had invasive disease at resection. Even with occult invasion, high-risk features were rare, and 5-year overall survival (OS) was nearly 80% with resection. Female sex, Black race, and specific subsites were associated with greater odds of occult invasive disease. The study supports the practice of definitive resection following biopsy demonstrating oral cavity CIS, emphasizing the importance of informed management decisions.
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