High Failure Rates in Young Nonsmoker Nondrinkers With Squamous Cell Carcinoma of the Oral Tongue. (18th June 2022)

• Record Type: Journal Article
• Authors: Jones, Brianna M.; Villavisanis, Dillan F.; Lehrer, Eric J.; Dickstein, Daniel R.; Sindhu, Kunal K.; Misiukiewicz, Krzysztof J.; Posner, Marshall; Liu, Jerry T.; Gupta, Vishal; Sharma, Sonam; Roof, Scott A.; Teng, Marita; Genden, Eric M.; Bakst, Richard L.
• Is Part Of: Laryngoscope. Volume 133:Number 5(2023)
• Page Start: 1110
• Page End: 1121
• Publication Date: 2022-06-18
• Subjects: distant failure -- non‐drinking -- non‐smoking -- oral tongue cancer -- young patients; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.30253
• Languages: English
• ISSNs: 0023-852X

Abstract

Abstract : Objective(s): There has been a disproportionate increase in the incidence of young patients with squamous cell carcinoma of the oral tongue (SCCOT). The purpose of this study was to compare young patients to older patients with SCCOT without prior drinking or smoking history as this population is poorly characterized in the literature. Methods: A retrospective review of patients presenting to our institution with SCCOT was performed. The clinical and pathologic characteristics, as well as, outcomes were compared between younger patients (age ≤45) and older patients (age >45). Outcome analysis was performed using Kaplan Meier method. Multivariable Cox proportional hazard models were performed for age and stage. Results: Eighty‐two patients (38 young, 44 old) were included in this study. Median follow‐up was 29.4 months. When compared to the older cohort (age >45), the younger cohort (age ≤45) demonstrated lower rates of 5‐year locoregional control (LC) (79.6% vs. 52.5%, p = 0.043) and distant metastasis‐free survival (88.1% vs. 61.8%, p = 0.006). Both cohorts demonstrated similar overall survival rates (55.5% vs. 58.1%) and disease‐specific survival (66.2% vs. 58.1%). Of patients experiencing locoregional failure with available radiation therapy plans and PET scans in younger cohorts ( n = 7), 100% demonstrated in‐field failures. Multivariable Cox proportional hazards demonstrated age was an independent predictor of DMFS ( p = 0.004) and the advanced stage was a predictor of DSS ( p = 0.03). Conclusions: Young, nondrinker, nonsmokers with SCCOT demonstrate high rates of locoregional recurrence, distant metastasis, and in‐field failures. Future studies are warranted to determine underlying mechanisms driving pathogenesis in this unique cohort. Level of Evidence: 3 Laryngoscope, 133:1110–1121, 2023 Abstract : The purpose of this study was to compare young patients to older patients with SCCOT without prior drinking or smoking history as this population is poorly characterized in the literature. Young, nondrinker, nonsmokers with SCCOT demonstrate high rates of locoregional failure, distant metastasis, and in‐field failures. Future studies are warranted to determine underlying mechanisms driving pathogenesis in this unique cohort.