Squamous cell carcinoma of the tongue in patients older than 45 years

Abstract: This study aims to evaluate the clinicopathological features, TNM status, AJCC staging and behavior of squamous cell carcinoma of the tongue (SCCT) in patients older than 45 years. The files of the Department of Pathology of the Hospital General de México were reviewed and all cases of SCCT in patients older than 45 years were selected. Clinicopathological features, treatment, follow-up, microscopic diagnosis, and IJCC and TNM staging were retrieved. Complete data from 60 cases were evaluated. They were more common in males (mean age = 63.9 years). Unexpectedly a high rate of tumors (38.3%) were in the base of the tongue (BT). Moderately and poorly differentiated SCCT were the most common. 16.7% presented lymph node invasion, 15% were recurrent tumors and BT carcinomas recurred more frequently. A high rate (81.7%) were stage II and 48.3% were low-risk patients. SCCTs in the studied population displayed different clinico-pathological and behavioral features compared with worldwide data. Our results suggest that BT tumors should be treated more aggressively than those in the mobile tongue. BT located tumors were more frequent than previously published. Additional frequency studies will define outcomes in age cohorts with a consensus cut-off for young and elderly populations. More population-based studies should be performed in Latin American regions to acquire accurate data on SCC incidence in elder subpopulations and to identify precisely the etiological factors in these patients.

摘要：本研究旨在评估45岁以上舌鳞状细胞癌（squamous cell carcinoma of the tongue, SCCT）患者的临床病理特征、TNM分期、美国癌症联合委员会（American Joint Committee on Cancer, AJCC）分期及肿瘤生物学行为。本研究回顾了墨西哥总医院病理科的病例档案，筛选出所有45岁以上舌鳞状细胞癌患者的病例，收集其临床病理特征、治疗方案、随访资料、显微镜下诊断结果以及IJCC分期与TNM分期相关数据。最终纳入60例资料完整的病例进行分析。本研究队列中男性患者占比更高，平均年龄63.9岁。出乎意料的是，38.3%的肿瘤位于舌根部（base of the tongue, BT）。病理分型以中分化及低分化舌鳞状细胞癌最为常见。16.7%的患者存在淋巴结侵袭，15%的病例为复发性肿瘤，且舌根部肿瘤的复发率更高。81.7%的病例为II期肿瘤，48.3%的患者属于低风险人群。与全球已发表的相关研究数据相比，本研究队列中的舌鳞状细胞癌展现出不同的临床病理特征与生物学行为模式。本研究结果提示，舌根部肿瘤应相较于活动舌部肿瘤采取更为积极的治疗策略。舌根部肿瘤的发生率较既往报道更高。后续需开展更多发病率相关研究，结合青年与老年人群的统一截断值，以明确不同年龄队列的预后结局。在拉丁美洲地区应推进更多基于人群的研究，以获取老年亚群舌鳞状细胞癌发病率的准确数据，并精准识别此类患者的病因学因素。