Curioso Pedro Augusto Bulhões, Correia Neto Ivan José, Souza Lucas Lacerda de, Santos Edilmar de Moura, Santos-Silva Alan Roger, Vargas Pablo Agustin, Lopes Marcio Ajudarte
Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Dnepartment of Oral Diagnosis, Piracicaba, SP, Brazil.
Hospital Dr. Luiz Antonio, Department of Education and Research, Natal, RN, Brazil.
Braz Oral Res. 2024 Dec 20;38:e138. doi: 10.1590/1807-3107bor-2024.vol38.0138. eCollection 2024.
The aim of this study was to perform a clinicopathological analysis of oral squamous cell carcinoma (OSCC) in young patients from the northeast of Brazil and compare with elderly individuals. This retrospective study reviewed 104 OSCC cases from 2000 to 2015, focusing on patients under 40 and over 60 at diagnosis. Forty-two patients under 40 years old (40.38%) and 62 patients over 60 years old (59.62%) were analyzed using descriptive statistics, chi-square, and Fisher's exact tests for clinicopathological factors, and Kaplan-Meier and Cox models for survival and prognostics. Most of the patients were male, with younger patients having lower rates of smoking (45.24%) and alcohol use (28.57%) compared to older patients (82.30% and 40.32%, respectively). Younger patients had a higher prevalence of tongue cancer and smaller tumors but faced more compromised surgical margins, perineural invasion, local recurrence, regional metastasis, distant metastasis, and second primary tumors. Statistical findings highlighted age-related differences in clinicopathological features and indicated that despite similar overall survival rates, younger patients had a poorer prognosis related to local recurrences, regional recurrences, and second tumors. Perineural invasion emerged as an independent prognostic factor. The study suggests that younger OSCC patients require personalized management strategies to address their higher risk of adverse outcomes, with an emphasis on the prognostic significance of perineural invasion.
本研究旨在对巴西东北部年轻患者的口腔鳞状细胞癌(OSCC)进行临床病理分析,并与老年个体进行比较。这项回顾性研究回顾了2000年至2015年的104例OSCC病例,重点关注诊断时年龄在40岁以下和60岁以上的患者。对42例40岁以下患者(40.38%)和62例60岁以上患者(59.62%)进行了描述性统计、卡方检验和Fisher精确检验,以分析临床病理因素,并采用Kaplan-Meier和Cox模型分析生存和预后情况。大多数患者为男性,与老年患者(分别为82.30%和40.32%)相比,年轻患者吸烟率(45.24%)和饮酒率(28.57%)较低。年轻患者舌癌患病率较高,肿瘤较小,但手术切缘、神经周围侵犯、局部复发、区域转移、远处转移和第二原发肿瘤的情况更差。统计结果突出了临床病理特征的年龄差异,并表明尽管总体生存率相似,但年轻患者在局部复发、区域复发和第二肿瘤方面预后较差。神经周围侵犯是一个独立的预后因素。该研究表明,年轻的OSCC患者需要个性化的管理策略来应对其更高的不良结局风险,应重视神经周围侵犯的预后意义。