Carcinoma of the oral tongue in patients younger than 30 years: Comparison with patients older than 60 years

Objectives: The incidence of oral tongue squamous cell carcinoma is rising in young patients. This study evaluated the clinical, pathological, and prognostic characteristics of oral tongue squamous cell carcinoma in the under-30-year age group. Materials and methods: The computerized database of the Department of Otolaryngology-Head and Neck Surgery of a tertiary, university-affiliated medical center was searched for all patients with oral tongue squamous cell carcinoma treated by glossectomy with curative intent in 1996-2012. Data were collected by chart review. Results: Of the 113 patients identified, 16 (14%) were aged <= 30 years at presentation and 62 (55%) >60 years. Mean follow-up time was 30 months. Comparison by age group revealed no sex predilection and no differences in histologic grade or rates of advanced T-stage, perineural and vascular invasion, or nodal extracapsular extension. Rates of node-positive disease were 75% in the younger group and 19% in the older group (p < 0.001). Kaplan-Meier analysis yielded no between-group difference in disease-free or overall survival. Recurrence was documented in a similar proportion of patients (38% and 29.9%, respectively), but half the recurrences in the younger group were distant versus none in the older group (p = 0.01) All younger patients with recurrent disease died within 16 months of its appearance compared to 50% 3-year disease-specific survival in the older group. Conclusions: Oral tongue squamous cell carcinoma is more advanced at presentation in younger than in older patients, with higher rates of regional metastases and distant failure. Recurrent disease is more aggressive, with a fatality rate of 100%. (C) 2013 Elsevier Ltd. All rights reserved.