Survival estimates for young patients with tongue cancer: An analysis of the SEER database.

Abstract

e17549 Background: Carcinoma tongue is a common malignancy with increasing trend. Studies have suggested poor outcomes in young patients. To better understand ,we reviewed survival in young patients of tongue cancer from Surveillance and Epidemiologic and End Results (SEER) analysis. Methods: We identified 261 patients, aged 15 to 29 years, with squamous cell carcinoma tongue reported to SEER program between 2004 to 2015. Cases were categorized by age, sex, laterality, stage. Survival rates were compared using SPSS software. Results: The group had male to female ratio of 1.2:1, with a median age of 26 years. According to ICD-03, 85 patients (32.6%) had keratinizing variant of squamous cell carcinoma. About 40 patients (15.2%) had grade I, 161(61.7%) grade II and 46 (17%) – had grade III tumors. Out of 216 patients laterality was not paired in the majority (214-82%), while 24 (9.2%) had left side and 21 (8%) had right side primaries. According to the AJCC staging classification - 90 patients (34.5%) had stage I, 36 (13.6%)- stage II, 50 (18.9%)- stage III, and 83 (30%) as stage IV disease. Surgical procedures included- excisional biopsy in 13 patients (4.9%), 183 (69.3%) had wide local excision, 37 (14%) underwent radical excision of the tumor. Overall 193 patients were alive (73%), 40 patients (15.2%) died of cancer and 20 (7.6%) died of other causes. Average survival was 41 months (range 0-142 months). The median survival did not differ between male and female (35 vs 45, p = NS). Grade of the tumor had no impact on survival (33, 44 and 32 months-well, moderately and poorly differentiated respectively). Similarly keratinizing tumors had equal to other squamous non classified tumors ( 45 vs 31 months). The staging of the tumor was predictive of the survival(p < 0.01) .Median survival as per the stage was 62, 46, 36 and 20 months for stage I,II,III and IV respectively .There was no statistical difference based on laterality of the tumor( left sided 28 months vs right sided 22 months).As per TNM staging small lesions survived better : 60, 45, 17 and 13 months respectively for T1 ,T2 ,T3 and T4 size (p < 0.006). Nodal status was also strong predictor of the survival p < 0.001) , 49,45,31 and 19 months respectively for N0, N1, N2 and N3 tumors. Metastatic disease also shortened survival significantly (p < 0.001) , 42 month with M0, while 3 months only for M1 disease. Conclusions: In young patients with tongue cancer, stage of the disease, size of the tumor, nodal status has significant impact on survival. Other parameters like sex, histological type, grade of the tumor, laterality has no major impact.