Impact of age at diagnosis on clinicopathological outcomes of oral squamous cell carcinoma patients in Karachi

Abstract

Objective:A recent trend in diagnosis of oral cancer in young age is observed, however its impact on various clinicopathological parameters needs to be explored. The aim of the current study was to compare and analyze impact of age at diagnosis with clinicopathological parameters of oral squamous cell carcinoma patients.Methods:In this cross sectional study conducted at Department of Oncology Ziauddin Hospital Karachi, we included histologically confirmed cases of oral squamous cell carcinoma. The patients were categorized as young age group (40yrs and younger) and old age group (41 yrs and above). A total of 115 patients diagnosed between 2013 and 2016 were enrolled in the study. The variables considered were age at diagnosis, sex, site of lesion, positive family history, tumor grade, stage, uric acid level and survival.Results:A statistically significant difference was observed between two age groups in overall survival, uric acid level and positive family history of cancer. No significant difference was observed in tumor location, grade and stage.Conclusion:Majority of oral cancer patients present at an advanced stage irrespective of age at diagnosis but young age has an overall improved survival. Moreover, a positive family history of cancer in young age group mandates further exploration of possible role of genetic polymorphisms which might be responsible for early onset of the disease.

Older age is a risk factor associated with poor prognosis of patients with squamous cell carcinoma of the oral cavity

“…Considering that cancers of the oral cavity are highly frequent in southern Asia, the higher proportion in young people might indicate that the sociocultural lifestyle of the population, such as betel quid chewing and the use of tobacco and alcohol, plays an important role in this geographic or regional diversity [ 27 ]. In our study, the percentage of patients with early stage (Stage I–II, 50.68%) was lower than in western developed countries [ 20 ], but higher than other southern Asian regions (e.g., India, Thailand, Taiwan, and Japan) [ 11 , 14 , 17 , 19 , 28 – 30 ]. It is suggested that low socioeconomic status or related patient factors (e.g., education, diet, health care, and living conditions) may increase the risk of OC-SCC.…”

“…In many types of cancer, age at diagnosis is viewed as an independent predictor of outcome [11]. In the field of OC-SCC, there is no uniform category of "young" patients and previous analyses were performed using age thresholds ranging from 30 to 45 years of age [12][13][14][15][16][17][18][19].…”

“…Most patients (93.4%) are diagnosed at age 45 and above [9]. Traditionally, OCC occurs in the elderly during the 5th through the 7th decades of life; however, it has been reported to be increasing in incidence among younger populations globally, especially in young women [11].…”

Socio-demographic characteristics are related to the advanced clinical stage of oral cancer

“…This fact can be explained due to cellular aging and the decrease of the regenerative capacity of the cells, together with greater exposure to carcinogenic factors, which would make them more susceptible to the development of tumors. However, it is important to point out that there is an increasing tendency for oral cancer to occur in the younger population (24).…”

Current Aspects of Oral Squamous Cell Carcinoma in Pakistan: A Review

“…Mahmood et al, 2018 conducted their work at Ziauddin University Hospital (ZUH), Karachi. Involved 115 subjects.…”