Head and neck squamous cell carcinoma in the young patient.

Abstract

Squamous cell carcinoma of the upper aerodigestive tract most commonly develops in the sixth or seventh decade of life, usually in patients who have significant risk factors from smoking or alcohol use. A subgroup of patients less than 45 years old, however, develops squamous cell carcinoma of the head and neck in whom the role of tobacco or alcohol use is less clear in the etiology of their cancer. Furthermore, there has been considerable debate regarding the tumor biology in this group of patients and its effects on prognosis and overall survival. This paper reviews the current literature and controversies on the etiology and management of squamous cell carcinoma of the head and neck in young patients. Young patients with head and neck squamous cell carcinoma do not have a poorer prognosis or disease-specific survival. Young patients with squamous cell carcinoma of the head and neck have a similar prognosis to older patients. There is a trend, however, towards a higher regional recurrence in young patients with head and neck squamous cell carcinoma, suggesting that prophylactic neck treatment should be considered. Further research is needed to determine whether a subgroup of patients (young nonsmoking women with tongue cancer) have a worse prognosis and warrant more aggressive treatment.