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Squamous Cell Carcinoma of the Oral Tongue in Young Patients: Outcomes and Implications for Treatment

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Abstract

Squamous cell carcinoma oral tongue (SCCOT) in patients below 45 years is relatively uncommon in literature; however, there have been increasing trends in incidence. Previous studies showed conflicting data, with no conclusive evidence of differences in outcome compared with older patients. The aim of our study was to determine if younger patients with tongue cancer in India had different clinico-pathological characteristics, prognostic determinants or survival than their older counterparts. Retrospective analysis of 425 adult patients of SCCOT, with 114 patients < 45 years of age (younger group) and 311 patients ≥ 45 years of age (older group), treated with surgery and adjuvant as indicated. Clinical and pathological features were described. Survival analysis was performed using Kaplan Meier’s method and multivariate analysis was performed for recurrence and survival using Cox proportional hazards ratio. Younger patients had a higher incidence of adverse pathological features (APFs) like lymphovascular invasion (p = 0.01), perineural invasion (p = 0.009), poorer differentiation (p = 0.044), nodal involvement (p = 0.021), extranodal extension (p = 0.003) and local recurrence (p = 0.008). All of these factors were noted to impact survival. However, on multivariate analysis for APFs, age was not an independent predictor of recurrence or survival. Younger patients with squamous cell carcinoma of tongue have an increased risk of APFs and local recurrence. The clinical observation that young patients have a worse outcome is likely due to the association of APFs rather than age being an independent prognostic factor. Further study is required to show if tumour biology in this cohort is distinct.

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Authors and Affiliations

  1. Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ponekkara PO, Kochi, 682 041, India

    Narayana Subramaniam, Deepak Balasubramanian, Sivakumar Vidhyadharan, Samskruthi Murthy, Krishnakumar Thankappan & Subramania Iyer

  2. Sydney Head and Neck Cancer Institute, Chris O’Brien Lifehouse, Sydney, Australia

    Tsu-Hui Hubert Low, Jonathan R. Clark & Kan Gao

  3. Radiation Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India

    Anjali Menon

  4. Central Clinical School, The University of Sydney, Camperdown, Sydney, New South Wales, Australia

    Jonathan R. Clark

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  1. Narayana Subramaniam
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  2. Deepak Balasubramanian
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  3. Tsu-Hui Hubert Low
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  4. Sivakumar Vidhyadharan
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  5. Anjali Menon
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  6. Samskruthi Murthy
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  7. Krishnakumar Thankappan
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  8. Jonathan R. Clark
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  10. Subramania Iyer
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Correspondence to Deepak Balasubramanian.

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Subramaniam, N., Balasubramanian, D., Low, TH.H. et al. Squamous Cell Carcinoma of the Oral Tongue in Young Patients: Outcomes and Implications for Treatment. Indian J Surg Oncol 11, 274–280 (2020). https://doi.org/10.1007/s13193-020-01049-y

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  • DOI: https://doi.org/10.1007/s13193-020-01049-y

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