Siegelmann-Danieli N, Hanlon A, Ridge J A, Padmore R, Fein D A, Langer C J
Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
J Clin Oncol. 1998 Feb;16(2):745-53. doi: 10.1200/JCO.1998.16.2.745.
To evaluate the demographics, differential risk profile, and treatment outcome in patients with squamous cell carcinomas (SCCs) of the oral tongue according to age at diagnosis.
Patients with invasive SCC of the oral tongue who presented during the years 1985 to 1996 were identified using institutional tumor registry data. Demographics and clinical and pathologic characteristics were abstracted from the medical charts.
Eighty-eight patients were identified; 87 were included for analysis. Thirty patients were diagnosed at < or = 45 years of age and 57 at > or = 46 years. The groups showed comparable American Joint Committee on Cancer (AJCC) staging and male predominance. Prior exposure to tobacco and/or alcohol was noted in 40% and 82% of younger and older patients, respectively (P < .001); multiple smoking-related cancers occurred only in older patients (24.5% of older patients, P < .001). With median follow-up time of 29 months (younger group) and 21 months (older group), there were no significant differences in relapse rates, cancer-free survival (CFS), and overall survival (OS) rates (actuarial 5-year CFS rate, 48% and 54% in the younger and older patients, respectively; P = .91). Grouping patients according to smoking and/or alcohol history showed a trend toward better CFS in those with prior exposure to tobacco or alcohol compared with those with neither (5-year CFS rate, 60% and 38%, respectively, P = .11). In a multivariate analysis of all patients, with age used as a continuous parameter, only stage predicted CFS (P = .0019); for patients treated surgically with curative intent, only risk group predicted CFS (P = .0369).
Prognosis of oral tongue SCC was not affected by age at diagnosis. CFS rates tended to be worse in cases not related to prior tobacco or alcohol exposure. Multiple smoking-related cancers occurred only in older patients.
根据诊断时的年龄评估口腔舌鳞状细胞癌（SCC）患者的人口统计学、不同的风险特征及治疗结果。
利用机构肿瘤登记数据确定1985年至1996年间出现的口腔舌浸润性SCC患者。从病历中提取人口统计学以及临床和病理特征。
共确定88例患者；87例纳入分析。30例患者诊断时年龄≤45岁，57例患者诊断时年龄≥46岁。两组在癌症联合委员会（AJCC）分期及男性占优势方面具有可比性。分别有40%的年轻患者和82%的老年患者有既往烟草和/或酒精接触史（P<0.001）；多种与吸烟相关的癌症仅发生在老年患者中（老年患者的24.5%，P<0.001）。年轻组和老年组的中位随访时间分别为29个月和21个月，复发率、无癌生存率（CFS）和总生存率（OS）无显著差异（精算5年CFS率，年轻患者和老年患者分别为48%和54%；P = 0.91）。根据吸烟和/或饮酒史对患者进行分组显示，有既往烟草或酒精接触史的患者CFS有优于无接触史患者的趋势（5年CFS率分别为60%和38%，P = 0.11）。在对所有患者的多因素分析中，将年龄作为连续参数，仅分期可预测CFS（P = 0.0019）；对于接受根治性手术治疗的患者，仅风险组可预测CFS（P = 0.0369）。
口腔舌SCC的预后不受诊断时年龄的影响。与既往无烟草或酒精接触史的病例相比，CFS率在这类病例中往往更差。多种与吸烟相关的癌症仅发生在老年患者中。
