Survival Outcomes in Oral Tongue Cancer: A Mono-Institutional Experience Focusing on Age

被引:22
作者
Ansarin, Mohssen [1 ]
De Berardinis, Rita [1 ]
Corso, Federica [2 ,3 ,4 ]
Giugliano, Gioacchino [1 ]
Bruschini, Roberto [1 ]
De Benedetto, Luigi [1 ]
Zorzi, Stefano [1 ]
Maffini, Fausto [5 ]
Sovardi, Fabio [6 ]
Pigni, Carolina [7 ]
Scaglione, Donatella [8 ]
Alterio, Daniela [9 ]
Rocca, Maria Cossu [10 ]
Chiocca, Susanna [2 ]
Gandini, Sara [2 ]
Tagliabue, Marta [1 ,11 ]
机构
[1] European Inst Oncol IRCCS, IEO, Div Otolaryngol & Head & Neck Surg, Milan, Italy
[2] European Inst Oncol 1RCCS, IEO, Dept Expt Oncol, Milan, Italy
[3] Politecn Milan, Dept Math, DMAT, Milan, Italy
[4] Human Technopole, CADS, Ctr Anal Decis & Soc, Milan, Italy
[5] European Inst Oncol IRCCS, IEO, Div Pathol, Milan, Italy
[6] Policlin San Matteo, IRCCS, Dept Otorhinolaryngol, Pavia, Italy
[7] ASST Ovest Milanese, Dept Otorhinolaryngol, Legnano, Italy
[8] European Inst Oncol IRCCS, Div Data Manager, IEO, Milan, Italy
[9] European Inst Oncol IRCCS, Div Radiotherapy, IEO, Milan, Italy
[10] European Inst Oncol IRCCS, IEO, Dept Med Oncol Urogenital & Head & Neck Tumors Me, Milan, Italy
[11] Univ Sassari, Dept Biomed Sci, Sassari, Italy
来源
FRONTIERS IN ONCOLOGY | 2021年 / 11卷
关键词
tongue cancer; age; prognosis; head neck cancer; T-N tract; overall survival; SQUAMOUS-CELL CARCINOMA; YOUNG-PATIENTS; EPIDEMIOLOGY; NEUTROPHIL; HEAD;
D O I
10.3389/fonc.2021.616653
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective The prognostic role of age among patients affected by Oral Tongue Squamous Cell Carcinoma (OTSCC) is a topic of debate. Recent cohort studies have found that patients diagnosed at 40 years of age or younger have a better prognosis. The aim of this cohort study was to clarify whether age is an independent prognostic factor and discuss heterogeneity of outcomes by stage and treatments in different age groups. Methods We performed a study on 577 consecutive patients affected by primary tongue cancer and treated with surgery and adjuvant therapy according to stage, at European Institute of Oncology, IRCCS. Patients with age at diagnosis below 40 years totaled 109 (19%). Overall survival (OS), disease-free survival (DFS), tongue specific free survival (TSFS) and cause-specific survival (CSS) were compared by age groups. Multivariate Cox proportional hazards models were used to assess the independent role of age. Results The median follow-up time was 5.01 years (range 0-18.68) years with follow-up recorded up to February 2020. After adjustment for all the significant confounding and prognostic factors, age remained independently associated with OS and DSF (respectively, p = 0.002 and p = 0.02). In CSS and TSFS curves, the role of age seems less evident (respectively, p = 0.14 and p = 0.0.37). In the advanced stage sub-group (stages III-IV), age was significantly associated with OS and CSS with almost double increased risk of dying (OS) and dying from tongue cancer (CSS) in elderly compared to younger groups (OS: HR = 2.16 95%, CI: 1.33-3.51, p= 0.001; CSS: HR = 1.76 95%, CI: 1.03-3.01, p = 0.02, respectively). In our study, young patients were more likely to be treated with intensified therapies (glossectomies types III-V and adjuvant radio-chemotherapy). Age was found as a prognostic factor, independently of other significant factors and treatment. Also the T-N tract involved by disease and neutrophil-to-lymphocyte ratio >= 3 were independent prognostic factors. Conclusions Young age at diagnosis is associated with a better overall survival. Fewer younger people than older people died from tongue cancer in advanced stages.
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页数:14
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