Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany.
Department of Pathology, Campus Mitte, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany.
Curr Oncol. 2022 Feb 10;29(2):969-980. doi: 10.3390/curroncol29020082.
The number of patients under the age of 45 diagnosed with head and neck squamous cell carcinomas (HNSCC) is increasing, probably due to the incidence of oropharyngeal cancers. Comparisons of HNSCC in young and old patients regarding tumor site and survival in sample sizes of relevance are rarely published. The aim of the study was to analyze the differences in survival between age groups dependent on tumor site and the influence of oropharyngeal cancers on the rising rates of HNSCC in the young. The records of 4466 patients diagnosed with HNSCC were reviewed retrospectively. Patients younger than 45 years were divided further into four subgroups for specific age differences in the young. The influences of patient and clinicopathological characteristics on survival were assessed using Kaplan-Meier analyses. Among the patient cohort, 4.8% were younger than 45 years. Overall survival (OS) in these patients was better, with a 5-year OS of 66.1% (vs. 46.4%), while relapse-free survival (RFS) was better in the older patient population, with a 5-year RFS of 74.9% (vs. 68.1%). Decreased RFS in the young was found for advanced tumor stages and tumor sited at the larynx. Hypopharynx and advanced stages were independent risk factors for OS under 45 years. Overall, 44.4% of all HNSCC in patients under 30 years were nasopharyngeal cancers, and incidence decreased with age. The incidence of oropharyngeal cancers increased significantly with age. Better OS in the young may be explained by lower tumor and disease stages, whereas oropharyngeal tumors and HPV were not found to cause rising rates of HNSCC. Laryngeal malignancies in young patients might be related to an increased malignant potential and should, consequently, be treated as such.
45 岁以下被诊断患有头颈部鳞状细胞癌（HNSCC）的患者数量正在增加，这可能是由于口咽癌的发病率上升所致。关于肿瘤部位和生存情况，在具有相关样本量的年轻和老年患者之间进行比较的研究很少发表。本研究的目的是分析依赖肿瘤部位的不同年龄组之间的生存差异，以及口咽癌对年轻患者中 HNSCC 发病率上升的影响。回顾性分析了 4466 例 HNSCC 患者的记录。年龄小于 45 岁的患者进一步分为四个亚组，以研究年轻人中特定的年龄差异。使用 Kaplan-Meier 分析评估患者和临床病理特征对生存的影响。在患者队列中，有 4.8%的患者年龄小于 45 岁。这些患者的总体生存率（OS）更好，5 年 OS 为 66.1%（vs. 46.4%），而老年患者的无复发生存率（RFS）更好，5 年 RFS 为 74.9%（vs. 68.1%）。在年轻人中，肿瘤晚期和喉肿瘤部位与 RFS 降低有关。在 45 岁以下，低 RFS 与肿瘤分期和下咽部位相关。总体而言，30 岁以下所有 HNSCC 患者中有 44.4%为鼻咽癌，且发病率随年龄增长而降低。口咽癌的发病率随年龄显著增加。年轻人 OS 较好可能是由于肿瘤和疾病分期较低所致，而口咽肿瘤和 HPV 并未导致 HNSCC 发病率上升。年轻患者的喉恶性肿瘤可能与恶性肿瘤的潜在风险增加有关，因此应将其视为如此。
