Squamous cell carcinoma of the oral cavity and the oropharynx in patients less than 40 years of age: a 20-year analysis

Abstract

BackgroundSquamous cell carcinoma mainly afflicts patients older than 40 years of age however, few cases are seen in younger patients. The aim of this study therefore was to determine the incidence of squamous cell carcinoma of the oral cavity and oropharynx in patients less than 40 years of age with a view to assessing the prognosis over a period of time.MethodsThis was a 20 years retrospective review of patients who were histologically diagnosed with squamous cell carcinoma of the oral cavity and the oropharynx at the Department of Cranio-Maxillo-Facial Surgery of the Hannover Medical School, Germany and had not received treatment anywhere else. Records of these patients were analysed for age and sex distribution, tumour staging and differentiation, location, treatment given, recurrences and metastasis, time between diagnosis and death or last contact with patient, and possible cause of death. Comparisons were also made with patients older than 40 years of age.Results and discussionA total of 977 patients treated for squamous cell carcinoma of the oral cavity and the oropharynx in the 20-year period of this study were included. Thirty eight (3.9 %) of the overall patient population were under 40 years of age. Among these, 30 (78.9%) were males and 8 (21.1%) were females. The incidence was highest in the 30–39 year age group accounting for 31 (81.6%) of the 38 patients. The moderately differentiated carcinoma was commonest (24; 63.2%). The floor of the mouth had the highest number of tumours (15; 39.5%), but none was seen in the oropharynx. Surgery alone was the main stay of treatment given to 26 (68.4%) patients. At the end of the study period, 13 (34.2%) patients had died of the tumour and the 5-year survival rate was 66.2%. In the older patient group (>40 years), 42.7% died from the tumour and the 5-year survival rate was 57.6%.ConclusionThe results from the present study showed that young adults may have a better prognosis especially in terms of long term overall survival from oral and oropharyngeal carcinoma.

Clinical and histopathological evidence of oral squamous cell carcinoma in young patients: systematized review

“…Different results were published by some studies (19,22) , in which there was predominance on the floor of mouth, followed by the tongue, what indicates a slight difference from previous researches with young individuals (9,17) . This discrepancy in results about the anatomical site may happen due to the sample size in each study, and to the most frequent harmful habits in the studied population.…”

“…That imposes limitation on comparison and analysis of results. On the other hand, the majority of the studies considered individuals under 40 young and belonging to a special group of patients affected by OSCC (3,9,17,22) , which tends to affect mainly patients in the fifth and sixth decades of life (9) . OSCC occurs more frequently in males.…”

Demographic Risk Factors, Affected Anatomical Sites and Clinicopathological Profile for Oral Squamous Cell Carcinoma in a North Indian Population

“…Other studies from India and across reported that most of OSCC cases diagnosed as moderately differentiated OSCC (Ayaz et al, 2011;Udeabor et al, 2012). The clinico-pathological factor that influence the treatment outcome and likelihood of recurrence are advanced T stage or stage III-IV disease at diagnosis, including local regional nodal involvement, positive resection margins or the resection margins being very close to the tumor and thickness of tumor ≥7mm (Battoo et al, 2012;Hakeem et al, 2012).…”

Clinical findings and risk factors associated with oral cancer: a prospective study

“…In today's time there are 4% to 13% of the cases of oral squamous cell carcinoma that affects subjects younger than 45 years of age. [4][5][6][7][8][9][10] The most frequently affected site is tongue and it is seen generally amongst alcohol and tobacco users. 4,5 Squamous cell carcinoma of lower lip is generally seen amongst subjects with exposure to sunlight.…”

“…6 There has been differences in the etiological factors that are responsible for causing oral squamous cell carcinoma amongst young and elderly individuals as the young individuals are exposed to the risk factors like sunlight and tobacco for a short period of time. 9,[11][12][13][14][15] Oral squamous cell carcinoma occurring amongst the younger individuals have an increased aggressiveness and poor clinical prognosis when compared to those affecting the elderly subjects. 6,7,12,16,17 The prognosis of the condition is determined by the prognostic factors that would in turn determine the biological aggressiveness of the condition amongst the subjects.…”