Cervical Metastases and Outcome of Oral Squamous Cell Carcinoma in Young Patients: A Retrospective Study of 28 Years

Objectives: The continuous increase in the incidence of oral squamous cell carcinoma (OSCC) in young patients is more often confronting the surgeon with the question of how aggressive the surgical therapy should be, particularly in terms of lymph node dissection. This retrospective study presents data from young patients focusing on the occurrence of cervical metastasis (CM) and the prognosis. Materials and Methods: From 1984-2013, all patients with OSCC under the age of 45 years treated at our department were included focusing on epidemiological data, risk factors, metastatic behavior and outcome. Results: 100 patients (30%♀;70%♂), with an average age of 39±6a (♀:37±6a,♂:39±6a), were analyzed. 68% had a risk profile regarding consumption of tobacco and/or alcohol. The main localization was the tongue (40%), followed by the floor of the mouth (26%) and lower jaw (19%). Together only 15% werelocated in the upper jaw and buccal mucosa. 32% exhibited an advanced tumor stage (III/IV), and 25% already had a CM. The risk for CM significantly increased with the tumor size and the grading. Relapse (average after 30 months), but not the CM or tumor size, had a significant impact on the survival. Conclusions: The OSCC of young patients is mainly located in the tongue and shows an aggressive metastatic behavior. Clinical relevance: A selective neck dissection during the primary therapy should be performed for this patient group, similar to OSCC in older patients. As the most important prognostic factor for survival, long-term close monitoring to detect relapse is important.