Negative prognostic factors for head and neck cancer in the young.

PURPOSE To evaluate the prognosis of head and neck (HN) squamous cell carcinoma (SCC) diagnosed in young people (≤40 years), and to compare it with the typical older patients. METHODS The study population comprised 69 HN cancer patients below the age of 40 years. An equal-sized control group of older patients was pair-matched with the young cases. Cases and controls were compared for type and frequency of recurrence, in addition to survival. Tongue tumor specimens from 12 women of the study group (6 young and 6 old) were included in a pilot immunohistochemical analysis of estrogen receptors (ER) expression. RESULTS Young patients with early (T1,T2) tongue cancer had shorter overall survival (OS) than their matched controls, but the finding was marginally non-significant (p=0.056). In the young population, late neck metastasis was a particularly aggravating factor for survival (p=0.004). In the case of tongue SCCs, young women were at the greatest risk of recurrence than any other gender-age combination (p=0.006). However, only 8.3% of tumors expressed ER. CONCLUSION Early-stage tongue cancer, regional recurrence, and tongue SCCs in women are negative prognostic factors for young HN cancer patients. Treatment modifications targeting these subgroups might be beneficial.