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Oral Tongue Squamous Cell Carcinoma in Young Women: A Matched Comparison—Do Outcomes Justify Treatment Intensity?

DOI: 10.1155/2014/529395

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Abstract:

Background. The incidence of oral tongue squamous cell carcinoma (OTSCC) in young women is increasing with uncertain outcomes compared to traditional patients. Published outcomes data are at odds in this cohort of young women. Methods. Retrospective analysis comparing demographic, clinicopathologic, and outcomes data of women OTSCC patients younger than 45 years old matched 1?:?2 by stage with men both younger and older than 45 and women older than 45. Results. No disease-free or overall survival differences were found between cohorts. Young women were significantly more likely to receive radiation therapy, particularly in stage I disease, even when controlling for common pathologic indications. Conclusions. OTSCC in young women was not associated with worse outcomes compared to a matched cohort of other patients. Increased frequency of radiation treatment for this cohort may not be justified. 1. Introduction Oral tongue squamous cell carcinoma (OTSCC) is the most common tumor in the oral cavity with an estimated 12,770 new cases in the United States in 2012 [1]. According to a 2011 published analysis of SEER data, the overall incidence of OTSCC was stable from 1975 to 2007 but was increasing in women and more specifically increasing in the subset of young, white women [2]. Other publications have documented similar findings suggesting that there are gender differences in OTSCC incidence, pathogenesis, and outcomes [3, 4]. Venables and Craft (1967) and Byers (1975) discussed some of the unique disease patterns among tongue cancers in young, white women including possibly more aggressive tumor behavior and delays in initial diagnosis due to low clinical suspicion [5, 6]. Unfortunately, many of the same themes and uncertainties persist several decades later. Attempts to compare clinicopathologic characteristics and outcomes data of young patients with OTSCC to a more traditional patient cohort of older patients have yielded disparate results. Given that this discrepancy in reported outcomes influences treatment discussions and patient recommendations at our institutional level, we sought to review our own patients with OTSCC and analyze for differences among different cohorts. The aims of this study were to compare young women with OTSCC to a matched cohort of young men and older women with respect to (1) clinical and histopathologic characteristics, (2) primary surgical and adjuvant therapy regimens, and (3) disease-specific and overall survival. 2. Materials and Methods After approval from the Committee on Human Research (CHR 11-05565), a review of the

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