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Patients with RPLN metastasis had a significantly reduced 5-year overall survival (OS) and disease-free survival (DFS) compared to the non-RPLN metastasis group (OS 28% vs. 48%, p=0.001; DFS 25% vs. 41%, p=0.04. RPLN metastasis was not uncommon in HPSCC patients. Risk factors were PPW primary tumor, PPW invasion and cervical LN status. RPLN metastasis is a poor prognosticator for survival. RPLN metastasis was not uncommon in HPSCC patients. Risk factors were PPW primary tumor, PPW invasion and cervical LN status. RPLN metastasis is a