Blanchard Pierre, Belkhir Farid, Temam Stéphane, El Khoury Clément, De Felice Francesca, Casiraghi Odile, Patrikidou Anna, Mirghani Haitham, Levy Antonin, Even Caroline, Gorphe Philippe, Nguyen France, Janot François, Tao Yungan
Département de Radiothérapie, Gustave Roussy, Université Paris-Saclay, Villejuif, 94805, France.
Univ Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, 94270, France.
Eur Arch Otorhinolaryngol. 2017 Mar;274(3):1683-1690. doi: 10.1007/s00405-016-4419-1. Epub 2016 Dec 8.
There is controversy regarding prognosis and treatment of young patients with oral cavity cancer compared to their older counterparts. We conducted a retrospective case-matched analysis of all adult patients younger than 40 years and treated at our institution for a squamous cell carcinoma of the oral cavity. Only non-metastatic adult patients (age >18) with oral tongue cancer were eventually included and matched 1:1 with patients over 40 years of age, at least 20 years older than the cases, with same T and N category and treatment period. Sixty-three patients younger than 40 had an oral cavity squamous cell cancer out of which 57 had an oral tongue primary during the period 1999-2012, and 50 could be matched with an older control. No difference could be seen between younger and older patients with regard to overall, cancer-specific, or progression-free survival. The patterns of failure were similar, although in young patients, almost all failures occurred during the first 2 years following treatment. Although overall survival shows a trend toward lower survival in older patients, cancer-specific survival and analysis of pattern failure suggest that disease prognosis is similar between young and older adults with oral tongue cancer. Further work is needed to identify the younger patients with poorer prognosis who overwhelmingly fail during the first year after treatment and could benefit from treatment intensification. Until then, young adults ought to be treated using standard guidelines.
与老年口腔癌患者相比，年轻口腔癌患者的预后和治疗存在争议。我们对所有年龄小于40岁且在我院接受口腔鳞状细胞癌治疗的成年患者进行了一项回顾性病例匹配分析。最终仅纳入非转移性成年（年龄>18岁）口腔舌癌患者，并将其与年龄大于40岁、比病例至少大20岁、具有相同T和N分期以及治疗时期的患者进行1:1匹配。1999年至2012年期间，63名年龄小于40岁的患者患有口腔鳞状细胞癌，其中57例原发于口腔舌部，50例可与老年对照匹配。年轻和老年患者在总生存、癌症特异性生存或无进展生存方面未见差异。失败模式相似，尽管在年轻患者中，几乎所有失败都发生在治疗后的前2年。尽管总生存显示老年患者生存有降低趋势，但癌症特异性生存和失败模式分析表明，年轻和老年口腔舌癌患者的疾病预后相似。需要进一步开展工作以识别那些预后较差的年轻患者，他们在治疗后第一年绝大多数会出现失败，可能从强化治疗中获益。在此之前，年轻成年人应按照标准指南进行治疗。
