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Ferreira E Costa R, Leão MLB, Sant'Ana MSP, Mesquita RA, Gomez RS, Santos-Silva AR, Khurram SA, Tailor A, Schouwstra CM, Robinson L, van Heerden WFP, Tomasi RA, Gorrino R, de Prato RSF, Taylor AM, Urizar JMA, de Mendoza ILI, Radhakrishnan R, Chandrashekar C, Choi SW, Thomson P, Pontes HAR, Fonseca FP. Oral Squamous Cell Carcinoma Frequency in Young Patients from Referral Centers Around the World. Head Neck Pathol 2022; 16:755-762. [PMID: 35316511 PMCID: PMC9424469 DOI: 10.1007/s12105-022-01441-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/27/2022] [Indexed: 12/24/2022]
Abstract
Oral squamous cell carcinoma (OSCC) commonly affects older patients; however, several studies have documented an increase in its incidence among younger patients. Therefore, it is important to investigate if this trend is also found in different geographic regions. The pathology files of diagnostic and therapeutic institutions from different parts of the globe were searched for OSCC cases diagnosed from 1998 to 2018. Data regarding the sex, age, and tumor location of all cases, as well as the histologic grade and history of exposure to risk habits of cases diagnosed as OSCC in young patients (≤ 40 years of age) were obtained. The Chi-square test was used to determine any increasing trend. A total of 10,727 OSCC cases were identified, of which 626 cases affected young patients (5.8%). Manipal institution (India) showed the highest number of young patients (13.2%). Males were the most affected in both age groups, with the tongue and floor of the mouth being the most affected subsites. OSCC in young individuals were usually graded as well or moderately differentiated. Only 0.9% of the cases occurred in young patients without a reported risk habit. There was no increasing trend in the institutions and the period investigated (p > 0.05), but a decreasing trend was observed in Hong Kong and the sample as a whole (p < 0.001). In conclusion there was no increase of OSCC in young patients in the institutions investigated and young white females not exposed to any known risk factor represented a rare group of patients affected by OSCC.
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Affiliation(s)
- Rafael Ferreira E Costa
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Marina Luiza Baião Leão
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Maria Sissa Pereira Sant'Ana
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Syed Ali Khurram
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Artysha Tailor
- Unit of Oral and Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Ciska-Mari Schouwstra
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Liam Robinson
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Willie F P van Heerden
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Romina Gorrino
- Department of Pathology, Dental School, National University of Córdoba, Córdoba, Argentina
| | | | | | | | | | - Raghu Radhakrishnan
- Department of Oral Pathology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Chetana Chandrashekar
- Department of Oral Pathology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Siu-Wai Choi
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Peter Thomson
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, MG, Brazil.
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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Rodrigues-Fernandes CI, Arboleda LPA, Vargas PA, Lopes MA, Santos-Silva AR. Oral leukoplakia in adolescents: Report of a rare case and review of the literature. Oral Oncol 2021; 122:105565. [PMID: 34673455 DOI: 10.1016/j.oraloncology.2021.105565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 12/01/2022]
Abstract
The aim of this report was to describe a rare case of leukoplakia in a young patient without any risk factors for squamous cell carcinoma. An 18-year-old male patient presented with an asymptomatic white lesion on the right lateral border of the tongue. Microscopic examination of the excisional biopsy specimen displayed hyperkeratosis and acanthosis without epithelial dysplasia, which were consistent with the clinical diagnosis of oral leukoplakia. The patient is undergoing systematic and regular evaluation, and after 28 months of follow-up, no recurrence has been observed. This report showed that, although uncommon, adolescents and/or young adults can also be affected by oral potentially malignant disorders. Therefore, dentists should be aware of this condition to establish the proper diagnosis and management.
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Affiliation(s)
- Carla Isabelly Rodrigues-Fernandes
- Department of Oral Diagnosis, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
| | - Lady Paola Aristizabal Arboleda
- Department of Oral Diagnosis, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil; Department of Oral Biology and Oral Pathology, University of Pretoria, Pretoria, South Africa
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Chen S, Lin Z, Chen J, Yang A, Zhang Q, Xie C, Zhang X, Yang Z, Chen W, Song M. Older age is a risk factor associated with poor prognosis of patients with squamous cell carcinoma of the oral cavity. Eur Arch Otorhinolaryngol 2020; 277:2573-2580. [PMID: 32322960 PMCID: PMC7410825 DOI: 10.1007/s00405-020-05963-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/01/2020] [Indexed: 12/24/2022]
Abstract
Purpose Whether or not young patients with squamous cell carcinoma of oral cavity (OC-SCC) have a difference in prognosis remains a controversy. This study aimed to analyze the clinical characteristics and difference of survival rates between adult patients less than 40 years of age and those 40 years of age and older. Methods A retrospective analysis was conducted using the database of patients diagnosed with OC-SCC between 1990 and 2013 in the Sun Yat-sen University Cancer Center, but patients older than 85 years, younger than 18 years, or died within 6 months of diagnosis were excluded. Patients were categorized into two groups: the young group (< 40 years of age) and the older group (≥ 40 years of age). Cox regression, survival and subgroups analyses were performed. The primary endpoints included the rates of 5-year overall survival (OS) and disease-specific survival (DSS). Results A total of 1902 OC-SCC patients were identified. The percentage of female in the young group was significantly higher than that in the older group (40.27% vs 31.03%, p < 0.001). This study failed to find the difference in TNM classification or tumor stage between the two groups (p > 0.05). The young group was more likely to receive adjuvant radiotherapy and/or chemotherapy (42.48% vs 26.91%, p < 0.001). The 5-year OS rate (71% vs. 57%, p < 0.001) and DSS rate (72% vs 58%, p < 0.001) in patients under 40 years were significantly higher than those for the older group. Conclusion Our findings suggested that OC-SCC in younger patients did not present at a more advanced stage. In addition, young age is an independent predictor for better survival.
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Affiliation(s)
- Shuwei Chen
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Zhu Lin
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Jingtao Chen
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Ankui Yang
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Quan Zhang
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Chuanbo Xie
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Cancer Prevention Center, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Xing Zhang
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Zhongyuan Yang
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China
| | - Wenkuan Chen
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China. .,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China. .,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.
| | - Ming Song
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China. .,State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China. .,Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Dong Road, Guangzhou, 510060, Guangdong, China.
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Morais-Faria K, Palmier NR, de Lima Correia J, de Castro Júnior G, Dias RB, da Graça Pinto H, Lopes MA, Ribeiro ACP, Brandão TB, Santos-Silva AR. Young head and neck cancer patients are at increased risk of developing oral mucositis and trismus. Support Care Cancer 2020; 28:4345-4352. [PMID: 31912359 DOI: 10.1007/s00520-019-05241-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 12/10/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To evaluate cancer treatment-related toxicities in young head and neck cancer (HNC) patients. MATERIAL AND METHODS A total of 44 patients were included in the present retrospective cohort study, which was designed to access oral toxicities of cancer treatment in young (< 45 years of age, Group I, n = 22) and old (> 58 years of age, Group II, n = 22) HNC patients with similar tumor stage and treatment protocols. Oral mucositis (OM), xerostomia, dysphagia, dysgeusia, trismus, and radiodermatitis were assessed during days 7th, 21st, and 35th of head and neck radiotherapy (HNRT) according to previously validated scales (World Health Organization criteria and the National Cancer Institute and Common Terminology Criteria for Adverse Events version 4.0). RESULTS Patients from both groups showed high incidence and severity of oral toxicities by the end of the HNRT with OM (81.9% (Group I); 63.6% (Group II)) and xerostomia (72.6% (Group I); 77.2% (Group II)) being the most prevalent toxicities. No differences regarding xerostomia, dysphagia, dysgeusia, and radiodermatitis incidences or severity could be observed between groups. However, higher incidences and severity of OM at 21st and 35th fractions (odds ratio = 2.22 and 5.71, respectively) and trismus at 21st and 35th fractions (odds ratio = 6.17 and 14.5, respectively) were observed throughout the treatment in young patients when compared to older patients (p < 0.01 and p < 0.05, respectively). CONCLUSION Young HNC patients are more affected by cancer treatment-related OM and trismus despite the similarities in clinical staging and treatment protocols with elderly patients.
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Affiliation(s)
- Karina Morais-Faria
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil
| | - Natalia Rangel Palmier
- Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, UNICAMP, 901, Av. Limeira, Areão, Piracicaba, São Paulo, 13414-903, Brazil
| | - Jaqueline de Lima Correia
- Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, UNICAMP, 901, Av. Limeira, Areão, Piracicaba, São Paulo, 13414-903, Brazil
| | - Gilberto de Castro Júnior
- Clinical Oncology Service, São Paulo State Cancer Institute (ICESP), School of Medicine of the University of São Paulo, São Paulo, Brazil
| | - Reinaldo Brito Dias
- Department of Maxillofacial Surgery, Prosthesis and Traumatology, USP, São Paulo, Brazil
| | | | - Marcio Ajudarte Lopes
- Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, UNICAMP, 901, Av. Limeira, Areão, Piracicaba, São Paulo, 13414-903, Brazil
| | | | - Thaís Bianca Brandão
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil. .,Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, UNICAMP, 901, Av. Limeira, Areão, Piracicaba, São Paulo, 13414-903, Brazil.
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5
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Ambele MA, Pepper MS, van Heerden MB, van Heerden WFP. Molecular profile of tongue cancer in an 18-year-old female patient with no recognizable risk factor. Laryngoscope Investig Otolaryngol 2019; 4:310-313. [PMID: 31236464 PMCID: PMC6580056 DOI: 10.1002/lio2.266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/28/2019] [Accepted: 04/09/2019] [Indexed: 12/27/2022] Open
Abstract
Background The occurrence of oral tongue squamous cell carcinoma (TSCC) in nonsmoking young adults, especially females, has increased. Yet, there is no clear evidence to support the existence of any single determinant. This case reports the presence of TSCC in an 18-year-old female with no recognizable risk factor for oral cancer development. Methods Histological examination and p16 immunohistochemistry were performed. Formalin-fixed paraffin-embedded sections were prepared from resected tissue and DNA was extracted for molecular OncoScan analysis. Results Histological and immunochemical analysis showed a p16-negative poorly differentiated keratinizing squamous cell carcinoma. OncoScan analysis of this tumor revealed a high confidence TP53:p.R213*:c.637C>T somatic mutation as well as copy number alterations of chromosomal regions including gains of 1p, 3q, 5p, 7p, 8p, 8q, 11q, 15q, 17q, and 20p, and losses on 1p, 3p, 18q, and 22q. Conclusion The TP53:p.R213*:c.637C>T mutation detected is indicative of a genetic predisposition to cancer and it is the first to be reported in TSCC in a nonsmoking young adult. Level of Evidence Case report.
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Affiliation(s)
- Melvin A Ambele
- Department of Immunology, and SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences Institute for Cellular and Molecular Medicine, University of Pretoria Pretoria South Africa.,Department of Oral Pathology and Oral Biology School of Dentistry, Faculty of Health Sciences, University of Pretoria Pretoria South Africa
| | - Michael S Pepper
- Department of Immunology, and SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences Institute for Cellular and Molecular Medicine, University of Pretoria Pretoria South Africa
| | - Marlene B van Heerden
- Department of Oral Pathology and Oral Biology School of Dentistry, Faculty of Health Sciences, University of Pretoria Pretoria South Africa
| | - Willie F P van Heerden
- Department of Oral Pathology and Oral Biology School of Dentistry, Faculty of Health Sciences, University of Pretoria Pretoria South Africa
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Cariati P, Cabello-Serrano A, Perez-de Perceval-Tara M, Monsalve-Iglesias F, Martínez-Lara I. Oral and oropharyngeal squamous cell carcinoma in young adults: A retrospective study in Granada University Hospital. Med Oral Patol Oral Cir Bucal 2017; 22:e679-e685. [PMID: 29053649 PMCID: PMC5813985 DOI: 10.4317/medoral.21755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/30/2017] [Indexed: 11/26/2022] Open
Abstract
Background This study aims to evaluate and analyze the clinical features and outcomes of oral and oropharyngeal squamous cell carcinoma (SCC) in patients < 45-years old in our center. Material and Methods A retrospective analysis was conducted using the records of patients diagnosed with oral and oropharyngeal SCC between 1998 and 2011 in the University Hospital of Granada (Spain). The analysis identified 33 patients with oral and oropharyngeal SCC with an age of <45 years. Moreover, during the years studied, a further 472 patients were diagnosed with oral and oropharyngeal SCC in our center. Thus, 100 SCC patients with an age of >45 years were randomly selected from the same database. A retrospective analysis was conducted to determine specific features including sites of occurrence, risk factors, sex distribution, socio-economic status, T stage at diagnosis, nodal involvement, degree of tumor differentiation, locoregional failure and overall survival at 5 years was. Further, the results of both groups were compared. Results The male-female ratio was 1.2:1 in the group of young adults and 2.03:1 in the group of patients with an age of >45 years. No significant differences were found in terms of site, nodal involvement, locoregional failure, and overall survival. However, there were statistically significant differences between the two groups in terms of features such as risk factors, socio-economic status, T stage at diagnosis, and degree of tumor differentiation. The overall 5-year survival rate was 62% for patients >45 years old, whilst for the group of young adults this rate was 48.4% (p= 0.17). Conclusions The poor association between the common risk factors and oral and oropharyngeal cancers in young adults suggests that other pathogenic mechanisms should be investigated. For young patients, the data show evidence of poorer outcomes in terms of overall survival (p=0.17), and locoregional failure (p=0.23). Nevertheless, the literature shows that the results in this field are particularly inconsistent, and further research is therefore needed to provide more in-depth knowledge of the disease in this age group. Key words:Oral and oropharyngeal squamous cell carcinoma, young adults, poor prognosis,risk factors.
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Affiliation(s)
- P Cariati
- Hospital Virgen de las Nieves, Carretera de Jaen s/n, Granada 18013 (Spain),
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