Prognostic Significance of Regional Disease in Young Patients with Oral Cancer: A Comparative Study.

disease free survival disease specific survival oral squamous cell carcinoma overall survival young patients

Journal

The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378

Informations de publication

Date de publication:
15 Nov 2023
Historique:
revised: 29 10 2023
received: 13 06 2023
accepted: 03 11 2023
medline: 15 11 2023
pubmed: 15 11 2023
entrez: 15 11 2023
Statut: aheadofprint

Résumé

Regional metastases are considered the most important prognostic factor in OSCC patients. We aimed to investigate the impact of regional disease among different age groups with OSCC. A retrospective comparison between patients 40 years old or younger, 41-69 years old, and 70 years or older treated for OSCC between 2000 and 2020 in a tertiary-care center. 279 patients were included. The mean age was 65 ± 17.7 and 133 were male (47.7%). Thirty-six (12.9%) were 40 years old or younger, 101 (36.2%) were 41-69 years and 142 (50.9%) were 70 years or older. Five-year overall survival and disease-specific survival (DSS) were significantly better among patients younger than 40 compared to the mid-age group and patients 70 years or older (76.7% vs. 69.4% vs.48.2%, Log-rank p < 0.001, and 76.7% vs. 75.3% vs. 46.5%, Log-rank p < 0.001, respectively). While an association between regional spread and overall survival and DSS was demonstrated among all age groups, the odds ratio (OR) for death of any cause and death of disease regarding cervical metastasis was much higher among patients younger than 40 compared with the 41-69 and 70+ age groups (death of any cause-OR = 23, p-value = 0.008, OR = 2.6, p-value = 0.026, OR = 2.4, p-value = 0.13, respectively. Death of disease-OR = 23, p-value = 0.008, OR = 2.3, p-value = 0.082, OR = 4.1, p-value = 0.001, respectively). In univariate  analysis, regional metastasis was associated with disease-free survival only among patients younger than 40 (p-value = 0.04). Regional metastases correspond with worse prognosis in young patients compared to older patients. These patients may benefit from a comprehensive treatment approach with close post-treatment follow-up. 3 Laryngoscope, 2023.

Sections du résumé

BACKGROUND BACKGROUND
Regional metastases are considered the most important prognostic factor in OSCC patients. We aimed to investigate the impact of regional disease among different age groups with OSCC.
METHODS METHODS
A retrospective comparison between patients 40 years old or younger, 41-69 years old, and 70 years or older treated for OSCC between 2000 and 2020 in a tertiary-care center.
RESULTS RESULTS
279 patients were included. The mean age was 65 ± 17.7 and 133 were male (47.7%). Thirty-six (12.9%) were 40 years old or younger, 101 (36.2%) were 41-69 years and 142 (50.9%) were 70 years or older. Five-year overall survival and disease-specific survival (DSS) were significantly better among patients younger than 40 compared to the mid-age group and patients 70 years or older (76.7% vs. 69.4% vs.48.2%, Log-rank p < 0.001, and 76.7% vs. 75.3% vs. 46.5%, Log-rank p < 0.001, respectively). While an association between regional spread and overall survival and DSS was demonstrated among all age groups, the odds ratio (OR) for death of any cause and death of disease regarding cervical metastasis was much higher among patients younger than 40 compared with the 41-69 and 70+ age groups (death of any cause-OR = 23, p-value = 0.008, OR = 2.6, p-value = 0.026, OR = 2.4, p-value = 0.13, respectively. Death of disease-OR = 23, p-value = 0.008, OR = 2.3, p-value = 0.082, OR = 4.1, p-value = 0.001, respectively). In univariate  analysis, regional metastasis was associated with disease-free survival only among patients younger than 40 (p-value = 0.04).
CONCLUSIONS CONCLUSIONS
Regional metastases correspond with worse prognosis in young patients compared to older patients. These patients may benefit from a comprehensive treatment approach with close post-treatment follow-up.
LEVEL OF EVIDENCE METHODS
3 Laryngoscope, 2023.

Identifiants

pubmed: 37965942
doi: 10.1002/lary.31187
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.

Références

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.
Deneuve S, Guerlain J, Dupret-Bories A, et al. Oral tongue squamous cell carcinomas in young patients according to their smoking status: a GETTEC study. Eur Arch Otorhinolaryngol. 2022;279(1):415-424. https://doi.org/10.1007/s00405-021-06793-7.
Lee DS, Ramirez RJ, Lee JJ, et al. Survival of young versus old patients with Oral cavity squamous cell carcinoma: a meta-analysis. Laryngoscope. 2021;131(6):1310-1319. https://doi.org/10.1002/lary.29260.
Gupta N, Gupta R, Acharya AK, et al. Changing trends in oral cancer-a global scenario. Nepal J Epidemiol. 2017;6:613-619. https://doi.org/10.3126/nje.v6i4.17255.
Ng JH, Iyer NG, Tan MH, Edgren G. Changing epidemiology of oral squamous cell carcinoma of the tongue: a global study. Head Neck. 2017;39:297-304. https://doi.org/10.1002/hed.24589.
Hussein AA, Helder MN, de Visscher JG, et al. Global incidence of oral and oropharynx cancer in patients younger than 45 years versus older patients: a systematic review. Eur J Cancer. 2017;82:115-127.
Oliver JR, Wu SP, Chang CM, et al. Survival of oral tongue squamous cell carcinoma in young adults. Head Neck. 2019;41(9):2960-2968.
Tota JE, Anderson WF, Coffey C, et al. Rising incidence of oral tongue cancer among white men and women in the United States, 1973-2012. Oral Oncol. 2017;67:146-152.
Valero C, Yuan A, Zanoni DK, et al. Young non-smokers with oral cancer: what are we missing and why? Oral Oncol. 2022;127:105803. https://doi.org/10.1016/j.oraloncology.2022.105803.
Patel SC, Carpenter WR, Tyree S, et al. Increasing incidence of oral tongue squamous cell carcinoma in young white women, age 18 to 44 years. J Clin Oncol. 2011;29(11):1488-1494.
Satgunaseelan L, Allanson BM, Asher R, et al. The incidence of squamous cell carcinoma of the oral tongue is rising in young non-smoking women: an international multi-institutional analysis. Oral Oncol. 2020;110:104875.
Nan-Chin L, Jui-Ting H, Kuo-Yang T. Difference between female and male patients with oral squamous cell carcinoma: a single-center retrospective study in Taiwan. Int J Environ Res Public Health. 2020;17(11):3978.
Shiboski CH, Schmidt BL, Jordan RC. Tongue and tonsil carcinoma: increasing trends in the U.S. population ages 20-44 years. Cancer. 2005;103(9):1843-1849. https://doi.org/10.1002/cncr.20998.
Oliver JR, Wu SP, Chang CM, et al. Survival of oral tongue squamous cell carcinoma in young adults. Head Neck. 2019;41:2960-2968. https://doi.org/10.1002/hed.25772.
Mahmood N, Hanif M, Ahmed A, Jamal Q, Saqib M, Khan A. Impact of age at diagnosis on clinicopathological outcomes of oral squamous cell carcinoma patients. Pak J Med Sci. 2018;34:595-599. https://doi.org/10.12669/pjms.343.14086.
Mukdad L, Heineman TE, Alonso J, Badran KW, Kuan EC, St. John MA. Oral tongue squamous cell carcinoma survival as stratified by age and sex: a surveillance, epidemiology, and end results analysis. Laryngoscope. 2019;129:2076-2081. https://doi.org/10.1002/lary.27720.
Blanchard P, Belkhir F, Temam S, et al. Outcomes and prognostic factors for squamous cell carcinoma of the oral tongue in young adults: a single-institution case-matched analysis. Eur Arch Otorhinolaryngol. 2017;274(3):1683-1690. https://doi.org/10.1007/s00405-016-4419-1.
Tomo S, Neto SC, Collado FU, et al. Head and neck squamous cell carcinoma in young patients: a 26-year clinicopathologic retrospective study in a Brazilian specialized center. Med Oral Patol Oral Cir Bucal. 2020;25(3):e416-e424. https://doi.org/10.4317/medoral.23461.
van Monsjou HS, Lopez-Yurda MI, Hauptmann M, van den Brekel MWM, Balm AJM, Wreesmann VB. Oral and oropharyngeal squamous cell carcinoma in young patients: The Netherlands cancer institute experience. Head Neck. 2013;35(1):94-102. https://doi.org/10.1002/hed.22935.
Hilly O, Shkedy Y, Hod R, et al. Carcinoma of the oral tongue in patients younger than 30 years: comparison with patients older than 60 years. Oral Oncol. 2013;49:987-990. https://doi.org/10.1016/j.oraloncology.2013.07.005.
Garavello W, Spreafico R, Gaini RM. Oral tongue cancer in young patients: a matched analysis. Oral Oncol. 2007;43(9):894-897. https://doi.org/10.1016/j.oraloncology.2006.10.013.
Sun Q, Fang Q, Guo S. A comparison of oral squamous cell carcinoma between young and old patients in a single medical center in China. Int J Clin Exp Med. 2015;8(8):12418-12423.
Jeon JH, Kim MG, Park JY, et al. Analysis of the outcome of young age tongue squamous cell carcinoma. Maxillofac Plast Reconstr Surg. 2017;39(1):41. https://doi.org/10.1186/s40902-017-0139-8.
Sklenicka S, Gardiner S, Dierks EJ, et al. Survival analysis and risk factors for recurrence in oral squamous cell carcinoma: does surgical salvage affect outcome? J Oral Maxillofac Surg. 2010;68(6):1270-1275. https://doi.org/10.1016/j.joms.2009.11.016.
Liao CT, Huang SF, Chen IH, et al. Outcome analysis of patients with pN2 oral cavity cancer. Ann Surg Oncol. 2010;17(4):1118-1126. https://doi.org/10.1245/s10434-009-0894-6.
Tsai TY, Iandelli A, Marchi F, et al. The prognostic value of lymph node burden in Oral cavity cancer: systematic review and meta-analysis. Laryngoscope. 2022;132(1):88-95. https://doi.org/10.1002/lary.29674.
Pantvaidya G, Rao K, D'Cruz A. Management of the neck in oral cancers. Oral Oncol. 2020;100:104476. https://doi.org/10.1016/j.oraloncology.2019.104476.
Llewellyn CD, Linklater K, Bell J, Johnson NW, Warnakulasuriya S. An analysis of risk factors for oral cancer in young people: a case-control study. Oral Oncol. 2004;40(3):304-313. https://doi.org/10.1016/j.oraloncology.2003.08.015.
Frare JC, Sawazaki-Calone I, Ayroza-Rangel AL, et al. Histopathological grading systems analysis of oral squamous cell carcinomas of young patients. Med Oral Patol Oral Cir Bucal. 2016;21(3):e285-e298. https://doi.org/10.4317/medoral.20953.
Troeltzsch M, Knösel T, Eichinger C, et al. Clinicopathologic features of oral squamous cell carcinoma: do they vary in different age groups? J Oral Maxillofac Surg. 2014;72:1291-1300.
Yosefof E, Hilly O, Stern S, Bachar G, Shpitzer T, Mizrachi A. Squamous cell carcinoma of the oral tongue: distinct epidemiological profile disease. Head Neck. 2020;42(9):2316-2320. https://doi.org/10.1002/hed.26177.
Bommakanti KK, Abiri A, Han AY, Goshtasbi K, Kuan EC, St John MA. Stage-specific survival in young patients with Oral tongue squamous cell carcinoma. Otolaryngol Head Neck Surg. 2022;168:398-406. https://doi.org/10.1177/01945998221101191.
D'Cruz AK, Vaish R, Kapre N, et al. Elective versus therapeutic neck dissection in node-negative Oral cancer. N Engl J Med. 2015;373(6):521-529. https://doi.org/10.1056/NEJMoa1506007.

Auteurs

Eyal Yosefof (E)

Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Nir Tsur (N)

Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ofir Zavdy (O)

Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Noga Kurman (N)

Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Institute of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel.

Dean Dudkiewicz (D)

Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Moshe Yehuda (M)

Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Gideon Bachar (G)

Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Thomas Shpitzer (T)

Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Aviram Mizrachi (A)

Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Sharon Tzelnick (S)

Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.
Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Classifications MeSH