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Clinicopathologic Characteristics of Young Patients with Oral Squamous Cell Carcinoma

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Abstract

Oral squamous cell carcinoma (OSCC) occasionally occurs in young patients and is likely to be distinct from OSCC in older patients. In this retrospective study, we described the clinicopathologic features and outcome of 150 OSCCs that were diagnosed in patients 40-year-old or younger. Most patients (63%) were non-smokers. The most common site of the primary tumor was oral tongue (n = 131, 87%), followed by gingiva (n = 9), buccal mucosa (n = 8) and lip (n = 2). The median patients' age at presentation was 34 (range: 16–40). Seven patients (5%) had Fanconi anemia with the gingiva being the most common location (4/7, 57%). All OSCCs were of keratinizing type. All cases tested for high-risk HPV (n = 34) were negative. On univariate analysis, high tumor budding was associated with decreased overall survival (OS) and distant metastasis free survival (DMFS), pattern of invasion correlated with OS and tumors with high stromal tumor infiltrating lymphocytes (sTIL) were associated with improved locoregional recurrence free survival (LRFS). Compared with patients 31 to 40-year-old, OSCC in the younger group was associated with significant less alcohol consumption (p = 0.011) and decreased DSS (p = 0.003) and DMFS (p = 0.023). On multivariate analysis, younger age (30 years or younger) was an independent prognostic factor for worse OS and DSS, whereas histologic grade was an independent prognostic factor for DSS. In summary, most OSCC in young patients occurred in non-smokers and did not occur in association with Fanconi anemia. Independent prognostic factors included age at presentation (30 years or younger) for OS and DSS, and histologic grade for DSS.

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Funding

Research reported in this publication was supported in part by the Cancer Center Support Grant of the National Institutes of Health/National Cancer Institute under award number P30CA008748. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors have disclosed that they have no significant relationships with, or financial interest in any commercial companies pertaining to this article.

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Authors and Affiliations

  1. Department of Pathology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Clevand, OH, USA

    Wadad S. Mneimneh

  2. Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Bin Xu, Charles Ghossein, Shenon Sethi, Anjanie Khimraj, Snjezana Dogan & Nora Katabi

  3. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Ian Ganly

  4. Department of Pathology, Mount Sinai Hospital, New York, NY, USA

    Bayan Alzumaili

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  1. Wadad S. Mneimneh
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Correspondence to Nora Katabi.

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All procedures performed in this retrospective study involving human participants were approved by the Institutional Review Board (IRB) in our institution. The research did not involve animals. Informed consent can be provided if needed.

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Mneimneh, W.S., Xu, B., Ghossein, C. et al. Clinicopathologic Characteristics of Young Patients with Oral Squamous Cell Carcinoma. Head and Neck Pathol 15, 1099–1108 (2021). https://doi.org/10.1007/s12105-021-01320-w

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