| Summary: | 碩士 === 高雄醫學大學 === 牙醫學研究所 === 98 === Abstract
Background
Oral cancer ranked as the 6th cancer death in Taiwan in 2008. It is even the 4th cancer death for male. According to recent studies, oral cancer is more prevalent in younger population than before. The clinic-pathologic feature and treatment outcome of the young patients are still controversial. Few studies about young patients in Taiwan are reported.
Objective
To compare the clinic-pathologic feature and survival rate between the young and middle-aged group patient. Further analysis is done to find out the prognostic factor for young oral cancer patients.。
Materials & Methods
We reviewed the cases treated in our hospital during Jan. 2002 and Dec. 2007. We defined the age less than 40 as young group. The control group is between 40 to 59 years old.
Chi-square test and t-test were used to compare the variables between the two groups. Kaplan-Meir is used to estimate the survival curve and then Log-rank test was used to determine if any difference subetween the survival curves. Finally, we use Cox’s proportion hazard ratio to find out the risk factors for both young and middle-aged group patients.
Results
Patient aged under 40 occupied 14.21% of all oral cancer patients. Most patients in the young-aged group are male. The percentage of female patient increased with age. The most common tumor site is tongue and the second common site is buccal mucosa for both age groups. The most common diagnosed stage is stage IV and the distribution in tumor stage is different between young and middle age group. In young-aged group, the most common histopathologic finding is moderate differentiation (MD). But in middle-aged group, the most common finding is well differentiation(WD).
The treatment is similar except in more advance-staged patients, young-aged group received radiotherapy than middle age group patient. Generally, the 2-year overall and disease-free survival rate for young age group is lower than middle age group and much lower survival rate for stage I and well-differentiated cancer in young age group.
Cell differentiation, tumor stage and treatment modality are the prognostic factors by univariate analysis for both age group. By multivariate analysis, OPCR(Operation combined chemotherapy and/or radiotherapy ) and CRT(chemotherapy and/or radiotherapy) treatment modality are the significant prognostic factors for young age group. The risk ratio is highest in CRT group.
Conclusion and Suggestion：
This study reveals that the survival rate of young age group is not significantly different from middle age group in most comparison condition. Difference only noted in WD(Well-differentiation) and Stage I group, but the cause still needs further investigation. Patients who receive radiotherapy and /or chemotherapy are with highest risk ratio. So operation should be considered as the most important curative treatment option and age is not the main prognostic factor in most condition.
Key word: Oral cancer, young age, Squamous cell carcinoma
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