Age and survival from squamous cell carcinoma of the oral tongue

Background. A worse outcome for young patients with head and neck squamous cell carcinoma has been previously suggested in the literature. This issue has been investigated with respect to squamous cell carcinoma of the oral t ongue. Methods. The Surveillance, Epidemiology and End Results (SEER) program tumo r registries were used. Cases of squamous cell carcinoma of the oral tongue (ICD-9 codes 141.1-141.5) diagnosed from 1988-1993 in which this cancer wa s the one and only cancer were included (n = 749). Disease-specific surviva l was evaluated with respect to age, type of surgical treatment, and radiot herapy white stratifying for stage using Cox proportional hazards analysis. A secondary analysis included the additional variables, tumor size and nod al status. (These fields were recorded in SEER for only about half of the c ases in the primary analysis.) Results. Analysis revealed that increasing age predicted worse disease-spec ific survival. A 10-year increase in age was associated with an 18% increas e in risk of death. Surgical therapy with excision of the primary tumor alo ne or excision plus neck dissection predicted improved survival, whereas th e use of radiotherapy was associated with worse survival. (The latter may r eflect bias associated with positive surgical margins or premorbid conditio ns.) In the secondary analysis, age, tumor size, and positive lymph node st atus were associated with significantly worse disease-specific survival, wh ereas surgical excision plus neck dissection was associated with improved s urvival. Conclusion. The SEER database shows increased disease-specific mortality wi th increasing age in patients with cancer of the oral tongue. Surgical ther apy is associated with improved survival, whereas the use of radiotherapy, increasing tumor size, and positive lymph node status are associated with w orse outcome. (C) 2001 John Wiley & Sons, Inc.