Comparison of Clinicopathological Profile of Oral Squamous Cell Carcinoma between Younger and Older Indian Adults

Abstract

Introduction: The relative incidence of Oral Squamous Cell Carcinoma (OSCC) seems to be increasing in young subjects and there is still no consensus regarding its pathogenesis, clinicopathological characteristics and prognosis in this population. Aim: The study aimed at evaluating the clinicopathological features of OSCC in younger patients and to determine any characteristic specific to this population in contrast to the older subjects. Materials and Methods: This was a single centre prospective study, conducted on 187 radical resection specimens of OSCC, between April 2015 and April 2020, at MS Ramaiah Medical College and Hospitals, Bengaluru. Of the study population 18.7% were young patients (≤40 years) and 81.3% were older patients. The clinical features and tumour characteristics were evaluated and the tumours were staged according to American Joint Committee on Cancer (AJCC) staging system. The characteristics in young patients (≤40 years) were compared to those of older patients. SPSS Version 18.0 software was used for statistical analysis. Chi-square test was used to determine any significant difference in the categorical variables. Results: Of the 187 patients, included in the study, 18.7%were young with a mean age of 36.8 years and male: female ratio of 1.3:1. Risk factor usage was present in 85.7% and family history of OSCC was present in 5.7% of the patients. Buccal mucosa was the commonest tumour site (54.3%) (significant p-value 0.031). Most patients presented at advanced TNM (Tumour Node Metastasis) stage (77.2%) and lymph node metastasis, extranodal extension and Worst Pattern Of Invasion (WOPI) were respectively present in 40%, 14.2% and 8.6% of the cases. Conclusion: Family antecedent of OSCC was higher in the young patients. Risk factor exposure and tumour characteristics like commonest anatomic site, morphology, differentiation and perineural invasion are relatively similar between the two age groups. Lymphovascular invasion, extranodal extension, WOPI, lymph node metastasis and presentation at advanced TNM stage were relatively more frequent, though not statistically significant, in the young suggesting a possibility of OSCC being more biologically aggressive in this population.

Keywords

• oral cancer
• risk factor
• squamous neoplasia
• tobacco
• tumour stage