Features of the clinical course and prognosis of tongue cancer in young women

Introduction. In recent times, changes in epidemiology of tongue cancer have been observed. morbidity among nonsmoking and non-abusing alcohol young women have been rising. Currently, etiology and pathogenesis of tumor development in this nosological group are unclear and require detailed analysis of epidemiologic and clinical data.

Aim. To analyze the clinical material on the incidence of tongue cancer among young women (under 45 years old) over a 10-year period and assess the prevalence of this pathology in this group, the methods of treatment and reconstruction used, and determine the prognosis.

Materials and methods. The study included 68 female patients with squamous cell carcinoma of the tongue who received treatment between 2010 and 2020. mean age was 36.8 years (between 18 and 45 years; median – 39 years). None of the patients had history of alcohol abuse or smoking. In 32 (47.1 %) patients, primary diagnosis was made at stages I–II, in 36 (52.9 %) at stages III–Iv.

Results. In the last 10 years, a trend towards increased morbidity of tongue cancer among young women have been observed. In 2010, 2 cases of the disease were detected, in 2019–13, in 2020–14. mean follow-up duration was 40 months (median 32 months). Overall 5-year survival in this period was 72.5 ± 6.5 %, recurrence-free 5-years survival was 66.5 ± 6.6 %. Conclusion. Increase on tongue cancer morbidity among young non-smoking women is a new epidemiological trend worldwide. Etiological and pathogenetic factors of this trend have not been studied and require large multicenter studies for obtaining statistically significant results. Early medical resource utilization in this social group allows to perform adequate surgical intervention but requires the head and neck tumor specialist to pay attention to reconstructive surgery, quality and early patient rehabilitation allowing to preserve high quality of life, capacity for work and social activity.

1. Amit M., Yen T.C., Liao C.T. et al. Improvement in survival of patients patients with oral cavity squamous cell carcinoma: an international collaborative study. Cancer 2013;199(24):4242–8. DOI: 10.1002/cncr.28357

2. Siegel R., Ward E., Brawley O., Jemal A. Cancer statistic 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer death. CA Cancer J Clin 2011;61(4):212–36. DOI: 10.3322/caac.20121

3. Listl S., Jansen l., Stenzinger A. et al. Survival of patients with oral cavity cancer in Germany. PLoS One 2013;8(1):e53415. DOI: 10.1371/journal.pone.0053415

4. Patel S.C., Carpenter W.R., Tyree S. et al. Increasing incidence of oral tongue squamous cell carcinoma in young white women, age 18 to 44 years. J Clin Oncol 2011;29(11):1488–94. DOI: 10.1200/JCO.2010.31.7883

5. Bleyer A. Cancer of the oral cavity and pharynx in young females: increasing incidence, role of human papiloma virus and lack of survival improvement. Semin Oncol 2009;36(5):451–9. DOI: 10.1053/j.seminoncol.2009.07.005

6. Auluck A., Hislop G., Bajdik C. et al. Trends in oropharyngeal and oral cavity cancer incidence of human papillomavirus related and HPV-unrelated sites in a multicultural population: the British Columbia experience. Cancer 2010;116(11):2635–44. DOI: 10.1002/cncr.25087

7. Ng J.H., Iyer N.G., Tan M.-H. et al. Chahging epidemiology of oral squamous cell carcinoma of the tongue: a global study. Head Neck 2017;39(2):297–304. DOI: 10.1002/hed.24589

8. Hussein A.A., Helder M.N., Visscher J.G. et al. Global incidence of oral and oropharynx cancer in patients younger than 45 years versus older patients: a systematic review. Eur J Cancer 2017;82:115–27. DOI: 10.1016/j.ejca.2017.05.026

9. Satgunaseelan L., Allanson B.M., Asher R. et al. The incidence of squamous cell carcinoma of oral tongue is rising in young nonsmoking women: an international multi-institutional analysis. Oral Oncol 2020;110:104875. DOI: 10.1016/j.oraloncology.2020. 104875

10. Papageorge M.B. Etiology of oral cancer in the young patient: is tongue cancer becoming the other cancer in women? Oral Maxillofac Surg Clin North Am 2007;19(2):163–71. DOI: 10.1016/j.coms.2007.01.004

11. Tota J.E., Anderson W.F., Coffey C. et al. Rising incidence of oral tongue cancer among white men and women in the United States, 1973–2012. Oral Oncol 2017;67:146–52. DOI: 10.1016/j.oraloncology.2017.02.019

12. Hadji P., Jacob L., Kostev K. Gender- and age-related treatment compliance in patients with osteoporosis in Germany. Patient Prefer Adherence. 2016;10:2379–85. DOI: 10.2147/PPA.S118396

13. Manteuffel M., Williams S., Chen W. et al. Influence of patient sex and gender on medication use, adherence, and prescribing alignment with guidelines. J Womens Health (Larchmt) 2014;23(2):112–9. DOI: 10.1089/jwh.2012.3972

14. Ji Y.B., Cho Y.H., Song C.M. et al. Long-term functional outcomes after resection of tongue cancer: determining the optimal reconstruction method. Eur Arch Otorhinolaryngol 2017;274(10):3751–6. DOI: 10.1007/s00405-017-4683-8

15. Wang X., Yan G., Zhang G. et al. Functional tongue reconstruction with the anterolateral thigh flap. World J Surg Oncol 2013;11:303. DOI: 10.1186/1477-7819-11-303

16. Yi C.R., Jeong W.S., Oh T.S. et al. Analysis of speech and functional outcomes in tongue reconstruction after hemiglossectomy. J Reconstr Microsurg 2020;36(7):507–13. DOI: 10.1055/s-0040-1709493

17. Cheng H.C., Yang C.C., Kao S.Y. et al. Evaluation of factors associated with the risk stratification of survivorship for stage IV squamous cell carcinoma of the oral cavity: a 10-year retrospective study. J Chin Med Assoc 2020;83(5):491–9. DOI: 10.1097/JCMA.0000000000000292

18. Ghantous Y., Abu Elnaaj I. [Global incidence and risk factors of oral cancer]. Harefuah 2017;156(10):645–9. (In Hebrew).

19. Zumsteg Z.S., Kim S., David J.M. et al. Impact of concomitant chemoradiation on survival for patients with T1–2N1 head and neck cancer. Cancer 2017;123(9):1555–65. DOI: 10.1002/cncr.30508

20. Kiyota N., Tahara M., Fujii M. Adjuvant treatment for postoperative head and neck squamous cell carcinoma. Jpn J Clin Oncol 2015;45(1):2–6. DOI: 10.1093/jjco/hyu195

21. Lin S.S., Massa S.T., Varvares M.A. Improved overall survival and mortality in head and neck cancer with adjuvant concurrent chemoradiotherapy in national databases. Head Neck 2016;38(2):208–15. DOI: 10.1002/hed.23869