Abstract
BACKGROUND: The rising incidence of oral tongue squamous cell carcinoma (OTSCC) among younger patients has raised concerns about a distinct clinical course in younger adults. This study investigated differences in demographics, clinicopathological profiles, and outcomes, such as locoregional control (LRC), distant metastasis-free survival (DMFS) and overall survival (OS), between younger (≤ 40 years) and older (> 40 years) OTSCC patients. MATERIALS AND METHODS: A retrospective analysis of 650 OTSCC patients treated between 2008 and 2022 at a cancer centre was conducted. Patients were categorized into younger (≤ 40 years, n = 189) and older (> 40 years, n = 461) groups. All patients underwent upfront surgery followed by adjuvant treatment. Univariate and multivariate analyses were performed to identify prognostic factors for LRC, DMFS and OS. RESULTS: There was no significant difference in 3-year LRC (younger: 53.7%, older: 56.5%, p = 0.300), DMFS (younger: 57.9%, older: 61.5%, p = 0.339), and OS (younger: 59.4%, older: 62.7%, p = 0.397), median LRC (younger: 49.1 months, older: 55.7 months, p = 0.863), median DMFS (younger: 75.4 months, older: 69.1 months, p = 0.749) or median OS (younger: 75.4 months, older: 72.4 months, p = 0.831). Tumour grade, margin status, perineural invasion (PNI), nodal stage (pN), and extracapsular extension (ECE) were significant predictors of LRC and OS, but age was not. CONCLUSION: Age is not an independent prognostic factor for OTSCC outcomes. Younger patients should not receive more aggressive treatment solely based on age. Treatment should follow standard care protocols for all OTSCC patients.