Younger Patients with Oral Tongue Squamous Cell Carcinoma Have Better Survival Rates

What are the differences in survival predictors in oral tongue squamous cell carcinoma (OTSCC) as stratified by age and sex?

BOTTOM LINE
OTSCC appears to present with relatively heterogeneous characteristics across different age groups and sexes. Despite the rising OTSCC incidence in young patients, they have improved survival rates compared to older patients.

Background: Recent epidemiological studies have noted the increasing incidence of head and neck cancer among young adults, including an increasing OTSCC incidence in young patients in a subset of data registries. Furthermore, a 2011 study noted an increasing OTSCC trend in young adults, most pronounced in white females, with a 111.3% increase from 1975 to 2007.

Study design: Retrospective, population-based database analysis of overall survival (OS) and disease-specific survival (DSS) of 16,423 cases of OTSCC between 1973 and 2013.

Setting: Surveillance, Epidemiology, and End Results (SEER) database.

synopsis: Of the included patients, 85.1% underwent surgery and 37.5% underwent radiation; only 27.1% of patients underwent both. The study cohort clinicopathologic data involved mainly early-stage tumors, with the majority T1 and N0. Younger patients were more likely to receive surgery and combination surgery/radiation compared to older patients. Young female patients had improved OS and DSS compared to young male patients. Young patients of either gender had improved OS and DSS compared to older patients. On multivariate analysis, tumor stage was uniformly associated with worse OS and DSS. Radiation treatment was associated with improved OS in older, but not younger, patients.

Across all groups, OTSCC subsite was not predictive of OS or DSS. Higher tumor grade predicted worse OS and DSS in older, but not younger, patients.

Limitations included the study’s retrospective nature that may misrepresent treatment and survival patterns given clinical management changes, and lack of information on surgery extent or approach, or chemotherapy and radiation therapy timing and modality.

Citation: Mukdad L, Heineman TE, Alonso J, et al. Oral tongue squamous cell carcinoma survival as stratified by ageand sex: a surveillance, epidemiology, and end results analysis. Laryngoscope. 2019;129:2076–2081.