The characteristics of head and neck squamous cell cancer in young adults: A retrospective single-center study

Abstract

We aimed to characterize clinical and prognostical factors of primary head and neck squamous cell carcinoma (HNSCC) in 85 young patients (≤39 years, median age: 37 years; between 2000–2018) in comparison with 140 institutional general HNSCC patients (median age: 61.5 years). The patient’s medical records were collected from the institutional database. The prevalence of smoking and alcohol consumption (65.8% and 48.1%) in the young group exceeded the regional population average but was below the institutional (86.4% and 55%) general HNSCC patient population. Primary tumor sites in the group of young patients were as follows: oral cavity (56.4%), oropharynx (17.6%), hypopharynx (11.7%), and larynx (14.1%). Cumulative five-year overall survival was 44.2% in the young group, but significantly better with early T (T1-2 vs. T3-4: 52.6% vs. 26.7%; p = 0.0058) and N0 status (N0 vs. N+: 65.2% vs. 32.3%; p = 0.0013). Young age, abstinence, earlier stage and laryngeal tumor site might predict a better prognosis. The age distribution and the high prevalence of traditional risk factors among the young patients as well as the predominance of oral cavity tumor localization suggest that the early onset of tumor development could be originated from the premature failure of the intrinsic protective mechanisms.

EZH2 Expression in Head-and-Neck Squamous Cell Cancer in Young Patients

“…This might originate either from defective cell cycle control or the dysfunctional clearance of malignant cells. In the latter scenario, tumor cells with a less aggressive phenotype might also survive, which might theoretically be in line with the more favorable survival data for young patients [6,7].…”

“…Furthermore, the age distribution of young patients was heavily distorted towards the cut-off value of 39 years, and the oral cavity-the site with the most environmental exposure-was the most common location among the young but not the general patient population. Our pilot results suggested that young HNSCC patients might have greater vulnerability to various carcinogens [6]. This might originate either from defective cell cycle control or the dysfunctional clearance of malignant cells.…”

“…To the best of our knowledge, our study is the first to examine EZH2 expression in this subgroup. Our previous results suggested that the early onset of HNSCC might originate from a greater vulnerability to environmental agents [6]. Either diminished damage control at the cellular level or a weaker capacity of the immune system to eliminate tumor cells might be responsible [24][25][26].…”

“…Although smoking and alcohol consumption are well-defined risk factors for HNSCC, the cumulative doses are lower in young individuals. We previously found the prevalence of tobacco and alcohol consumption among young HNSCC patients to be between that of the general regional population (>15 years) and the general HNSCC patient population [6]. Furthermore, the age distribution of young patients was heavily distorted towards the cut-off value of 39 years, and the oral cavity-the site with the most environmental exposure-was the most common location among the young but not the general patient population.…”

Predição De Óbitos Por C Ncer De Orofaringe No Brasil, 2022-2024, Utilizando Uma Série Histórica

“…Embora fatores de risco tradicionalmente associados (tabagismo e etilismo) estejam presentes nesses indivíduos, a duração da exposição não parece ser suficiente para o aumento do risco de câncer e, portanto, as causas para esse início precoce ainda não estão claras. 3 Mesmo com a redução da prevalência do tabagismo na maioria dos países de alta renda nos últimos 20 anos levando a um declínio na incidência do HNSCC, a infecção cancerígena pelo papilomavírus humano (HPV) emergiu como um importante fator de risco que tem levado a um aumento na incidência de câncer durante o mesmo período. 4,5 A relação entre a infecção por HPV, o surgimento de câncer na região de cabeça e pescoço e os mecanismos moleculares envolvidos têm se consolidado com o tempo.…”