Oral cancer in the young with no tobacco exposure: A distinct epidemiological subset?

Abstract

Objectives: To describe oral squamous cell carcinoma (OSCC) in the young (<45 years) with no tobacco exposure and identify the determinants of locoregional control and survival. Materials and Methods: This is a retrospective analysis of 82 young patients of OSCC with no tobacco exposure treated with surgery and adjuvant therapy. Survival analysis was performed, and determinants of control and survival were identified by Cox proportional hazards regression model. Results: Overall 67% were male, and the median age was 40 years. Survival was excellent: for Stages I, II, III, and IV, 5-year overall survival was 97%, 95%, 75%, and 64% and disease-free survival (DFS) was 84%, 79%, 57%, and 59%, respectively. On multivariable analysis, perineural invasion (PNI) predicted DFS and local and distant control. Conclusion: This cohort had excellent survival when treated appropriately with adjuvant therapy. PNI may represent the need for treatment escalation. Further study is required to identify if this is a biologically distinct cohort.