Histological features and survival in young patients with HPV-negative oral squamous cell carcinoma

Oral Dis. 2020 Nov;26(8):1640-1648. doi: 10.1111/odi.13479. Epub 2020 Jul 31.

Abstract

Objectives: The frequency of oral squamous cell carcinoma in young adults has increased in the last decades, and there are conflicting results in literature about its prognosis in young subjects. The aim of this study was to analyse the clinical and pathological features of oral squamous cell carcinoma in a cohort of young adults in order to investigate the presence of new independent prognostic markers.

Materials and methods: Only HPV-negative young patients (under 40-year-old) affected by oral squamous cell carcinoma were considered in this study. Clinical and pathological data were collected. Patients were re-staged according to the 8th edition of AJCC.

Results: Overall, 66 patients were considered in this study. Perineural invasion significant correlated with both 7th and 8th edition of AJCC, and lymphovascular invasion (p-value < .05). The multivariate survival analysis showed that patients with perineural invasion had a significant worse prognosis (HR = 6.384 95% C.I. 1.304-31.252; p-value = .022).

Conclusions: Perineural invasion emerged as an independent prognostic factor for disease-specific survival in young patients with oral squamous cell carcinoma. Furthermore, the evaluation of this parameter is simple, inexpensive and can be used to augment the risk stratification of oral cancer based on the 8th edition of AJCC.

Keywords: 8th edition AJCC; disease-specific survival; oral squamous cell carcinoma; perineural invasion; young age.

MeSH terms

  • Adult
  • Carcinoma, Squamous Cell* / pathology
  • Head and Neck Neoplasms*
  • Humans
  • Mouth Neoplasms* / pathology
  • Neoplasm Staging
  • Papillomavirus Infections* / complications
  • Prognosis
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Young Adult