Clinical features and outcomes in young adults with oral tongue cancer in young adults

Publication date: Available online 2 October 2018

Source: American Journal of Otolaryngology

Author(s): Courtney Miller, Aryan Shay, Bobby Tajudeen, Neilayan Sen, Mary Fidler, Kerstin Stenson, Paolo Gattuso, Samer Al-khudari

Abstract

Objective

To evaluate outcomes and survival in young patients with oral tongue cancer (OTC).

Methods

Retrospective chart review of patients aged 18–40 with OTC treated between 2000 and 2016. Tumor characteristics of p16 expression, perineural invasion (PNI), and lymph-vascular invasion (LVI) were evaluated. Recurrence-free (RFS) and overall survival (OS) data were analyzed according to Kaplan-Meier method with univariate analysis.

Results

A total of 23 patients were identified: 12 with early stage disease (ESD, stage I), and 11 with advanced stage disease (ASD, stage III or IV), (17 men and 6 women). Mean age at presentation was 34.5 years (±5 months) and mean follow-up was 46.6 months. For all patients, 5-year RFS was 62% and OS 66%. RFS for ESD was 73% and ASD 25% (log rank p = 0.011). OS for ESD was 100% and ASD 55% (log rank p = 0.012). 22% indicated tobacco use >5 pack-years and 9% heavy alcohol use. Factors associated with worse OS were neck disease (log rank p = 0.073), positive margins (log rank p = 0.001), and LVI (log rank p = 0.002). Factors associated with worse RFS were chemotherapy or radiation therapy prior to surgery (log rank p = 0.002), neck disease (log rank p = 0.047), positive margins (log rank p = 0.039), and PNI (log rank p = 0.001). Expression of p16 was observed in five cases and was not significantly associated with OS or RFS.

Conclusion

In young patients with OTC, factors associated with worse outcomes are similar to known predictors in older patients. p16 was not associated with improved OS. OS in patients with ESD was excellent (100%), and significantly worse for ASD.

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