Oral Squamous Cell Carcinoma in Young Patients–A Case-Control Analysis

Abstract

A subgroup of younger patients develop squamous cell carcinoma (SCC) of the oral cavity without identifiable risk factors. Controversy exists in the literature regarding the tumor biology and pathogenesis in this group of patients and its effects on prognosis and survival. A retrospective matched control study describing the outcome of 21 previously untreated oral cavity SCC patients less than 45 years old treated at a single institution from 2008 to 2016 was performed. The young patient group was compared with a control group of previously untreated patients greater than 45 years old matched for oral cavity subsite, pathologic TNM staging, and year of treatment. There was an equal distribution of T stages in the younger patient group with 7 T1, 8 T2, and 6 T3/T4. Younger patients were more likely to be never smokers (P= .017). There was no difference between younger and older patients with regards to overall survival (P = .771) and disease-free survival (P = .970). There was no statistical difference in adjuvant treatment modalities received between the two cohorts. The patterns of failure were similar between the two groups. All 9 young patients that recurred are deceased, including 2 patients who committed suicide. Young patients with oral cavity SCC do not have a worse prognosis than a matched older patient group in this case-controlled study. Further research is necessary to determine the pathogenesis of oral cavity SCC in young patients without identifiable risk factors and identify the subset of young oral cavity SCC patients with aggressive disease. Further support and clinical interventions are necessary to identify and prevent psychosocial distress in young head and neck cancer patients.