Main Session
Sep 29
PQA 07 - Head and Neck Cancer, Lung Cancer/Thoracic Malignancies, and Nursing and Supportive Care

3593 - Incidence Trends and Clinical Outcomes in Young Patients with Oral Cavity Cancer: A Multi-Decade Analysis from a Tertiary Care Center

03:45pm - 05:00pm ET
Poster Hall - Exhibit Hall A
Screen: 11
POSTER

Presenter(s)

Alexander Qian, MD - University of California San Francisco, San Francisco, CA

A. S. Qian1, S. M. Dufault2, J. Fortino3, S. S. Yom4, and J. W. Chan4; 1University of California San Francisco, San Francisco, CA, 2University of California, San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA, 3Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, 4University of California, San Francisco, San Francisco, CA

Purpose/Objective(s):

Oral cavity squamous cell carcinoma (OCSCC) in young adults is increasingly recognized as a potentially distinct clinical entity. We characterized temporal trends, treatment patterns, and survival outcomes among young patients with OCSCC over four decades at a single tertiary care center.

Materials/Methods:

We conducted a retrospective review of patients diagnosed with OCSCC from 1990-2025. Patients aged = 45 years at diagnosis were classified as young. Demographic, clinical, and treatment variables were summarized by decade. Temporal and age-related differences in survival were analyzed using Kaplan-Meier estimates and multivariable Cox regression models adjusted for TNM stage.

Results:

Among 2,461 patients with OCSCC, the proportion aged =45 years was stable over time (1990: 13%, 2000: 15%, 2010: 8.5%, 2020: 9.8%). Oral tongue was the most common subsite in both young and older adults, with a rising proportion across decades (1990: 49%, 2000: 59%, 2010: 73%, 2020: 80%; p=0.005). Slightly more young patients presented with T3-4 disease in recent years (1990: 21%, 2000: 23%, 2010: 34%, 2020: 48%; p=0.001). Use of multimodality therapy increased dramatically among young patients (1990: 39%, 2000: 27%, 2010: 60%, 2020: 66%; p < 0.001). After adjusting for TNM stage, young patients had worse 2-year progression-free survival (HR = 1.38, 95% CI 1.04-1.83, p = 0.027) but better 2-year overall survival (HR = 0.48, 95% CI 0.40-0.58, p < 0.001) than older adults.

Conclusion:

Rates of OCSCC have not increased in younger patients, but these patients have more locally advanced presentations and higher relapse rates, despite an increasing use of multimodality therapy. These findings suggest biological or treatment-related differences and emphasize the need to further study the etiologic drivers and optimize management in young patients with OCSCC.