Head and neck squamous cell carcinoma: Better to be young

Abstract

Most head and neck squamous cell carcinoma patients are elderly, with few younger than 40 years. Controversy exists in the literature regarding outcomes for younger patients. The goal of this research project was to compare baseline features and outcomes for young patients (</=40 years), middle-aged patients (41-64 years), and old patients (>/=65 years). To investigate the relationship between age and important presenting features and outcomes, 1160 recently diagnosed patients first treated at Washington University between 1980 and 1991 were identified from an existing database. Full 5-year survival information was available for 1030 patients (89%). Overall, the 5-year survival rate was 46% (478/1030); young patients (65%, 26/40) had a significantly better survival rate than middle-aged (52%, 292/566) or old patients (38%, 160/424) (chi(2) = 24.5; P = 0. 001). Survival was also related to smoking, comorbidity, primary site, TNM stage, and nodal disease. Age remained a significant factor even after we controlled for these other factors. Young patients developed fewer recurrent and new primary tumors. We conclude that young patients have a much better overall prognosis than older patients. The reasons for this difference are unclear, but it appears that the impact of age goes beyond an actuarial effect.

Impact of Young Age on the Prognosis for Oral Cancer: A Population-Based Study in Taiwan

“…Fridllander et al [8], Pitman et al [9], Vargas et al [10], Glory et al [11] and Pytynia et al [12] noted that there were no significant differences in outcome between the different age groups. However, McGrefor et al [13], Clark RM et al [14], Hafkamp et al [15], Carniol and Fried [16], and Lacy PD et al [17] all showed that the prognosis for young patients was better. Because of the disparity in the results of these studies, the question of outcome between different age groups remains unanswered.…”

Altered desmoplakin expression at transcriptional and protein levels provides prognostic information in human oropharyngeal cancer

“…These tumors are locally invasive, with frequent metastasis both to regional and distant organs [3]. Despite significant advances in therapeutic modalities treatment regimens, the presence of metastasis remains the major determinant of poor outcome for patients with OSCCs [4,5], and the survival rate is among the lowest of the major cancers [6].…”

Squamous Cell Carcinoma of the Oral Tongue in the Pediatric Age Group

“…In young patients with head and neck SCC, the oral tongue is the most common primary site 22,25,26. We report the outcomes of a pediatric cohort of patients with SCC of the oral tongue who were treated at a comprehensive cancer center and compare outcomes with those of an adult cohort matched for sex, smoking history, stage, and treatment modality.…”