Dados do Trabalho

Título

Analysis of clinicopathological features and prognosis of oral cavity squamous cell carcinoma: A single-center retrospective study of 35 years

Introdução

Oral cavity squamous cell carcinoma (OCSCC) is the most common malignancy of the head and neck world-wide. However, outcomes are still controversial in young adult patients, with several studies have attempted to investigate the prognosis and survival outcomes. Our study focuses on the clinicopathological features and prognosis in patients younger and older than 46 years.

Objetivo

To evaluate the impact of age at diagnosis and exposure, in young patients, to tobacco and alcohol in the prognosis of oral squamous cell carcinoma.

Métodos

We performed a retrospective study to investigate the association between survival and clinicopathological characteristics in patients with OSCC, treated at A.C. Camargo Cancer Center, Brazil from June 1, 1985, to June 31, 2020. The enrolled patients were stratified according to age in younger than 46 years and older than 46 years. The data of this study were obtained from hospital-based database. We collected information on demographic, clinical and pathological variables using a standard questionnaire. Continuous variables are described by mean and standard deviation while categorial variables by the frequency of unique values. The Student t-test was used for mean comparison and the chi-square test for proportion comparison. The Kaplan-Meier technique was used for description of survival and the Cox model for multivariable survival analysis. The outcomes of interest were disease-specific survival (DSS) and overall survival (OS). Ethical approval by number (2850/20B).

Resultados

There were 1,917 patients with OCSCC treated with curative intent. We found 285 (14.8%) young patients and 1,632 (85.2%) old patients. Significant differences were observed between the cohorts in tobacco (p<0.001), alcohol (p<0.001), pN stage (p=0.001), clinical stage (p=0.014), extranodal extension (p<0.001) and histological grade (p=0.023). No differences were observed in pT stage, lymphovascular invasion, neural infiltration, or adjuvant treatment although there was a trend towards wider use of chemoradiation in young patients (p=0.090). The five-years DSS was 67.7% and overall survival 56.8%. The log-rank test disclosed no significant difference between the cohorts, with a trend towards better OS in young patients (p=0.06). In multivariate analysis, pT and pN classification and adjuvant radiotherapy were significant for DSS while age was not. When considering only young patients, the lack of exposure to tobacco and/or alcohol implied in significantly worse prognosis.

Conclusões

In our center young adults with OCSCC experienced similar oncologic outcomes as older patients with OCSCC. Significant differences were found in preoperative staging and pathological features.

Palavras-chave

Oral cavity squamous cell carcinoma, young age, survival outcomes