Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Syogoin-Kawahara-cho, Sakyo-ku, Kyoto 650-8507, Japan; Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 650-8501, Japan.
Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 650-8501, Japan.
Oral Oncol. 2020 Nov;110:105010. doi: 10.1016/j.oraloncology.2020.105010. Epub 2020 Sep 17.
Whether the prognosis of tongue cancer differs between young patients and elderly patients remains controversial. We aimed to compare the clinical characteristics and prognoses of patients with young-onset and old-onset tongue cancer.
The retrospective cohort study utilized data from the Diagnosis Procedure Combination database maintained in Japan. Data derived from patients age ≥ 20 years diagnosed with tongue cancer between April 2008 and January 2019 were extracted from the database. Patients were divided into two groups based on age at tongue cancer diagnosis, a < 45 years group and a ≥ 45 years group. The primary outcomes were overall survival and disease-free survival, adjusted for age, sex, tumor classification, nodal metastasis, distant metastasis, smoking history, Charlson Comorbidity Index score, and tongue cancer treatment.
A total of 2315 patients diagnosed with tongue cancer were included in the study, of whom 1412 patients diagnosed based on the seventh edition of the Union for International Cancer Control in the multivariable Cox proportional hazards modeling. The adjusted hazard ratio for overall survival was 1.22 (95% confidence interval 0.66-2.24, p = 0.54) and that for disease-free survival was 1.14 (95% confidence interval 0.80-1.61, p = 0.47), and neither differed significantly between the two age groups.
The results of the present study suggest that younger age at the time of tongue cancer diagnosis may not be associated with a poorer prognosis. Young patients with tongue cancer should be treated in accordance with general guidelines.
舌癌患者的预后在年轻患者和老年患者之间是否存在差异仍存在争议。本研究旨在比较早发性和晚发性舌癌患者的临床特征和预后。
本回顾性队列研究使用了日本诊断程序组合数据库中的数据。从数据库中提取了 2008 年 4 月至 2019 年 1 月期间诊断为舌癌且年龄≥20 岁的患者数据。根据舌癌诊断时的年龄将患者分为两组，<45 岁组和≥45 岁组。主要结局指标为总生存率和无病生存率，通过年龄、性别、肿瘤分类、淋巴结转移、远处转移、吸烟史、Charlson 合并症指数评分和舌癌治疗进行调整。
本研究共纳入 2315 例诊断为舌癌的患者，其中 1412 例基于第七版国际癌症控制联盟的多变量 Cox 比例风险模型进行诊断。总生存率的调整后危险比为 1.22（95%置信区间 0.66-2.24，p=0.54），无病生存率的调整后危险比为 1.14（95%置信区间 0.80-1.61，p=0.47），两组间差异均无统计学意义。
本研究结果表明，舌癌诊断时年龄较小可能与预后较差无关。对于患有舌癌的年轻患者，应根据一般指南进行治疗。
