The role of tobacco in oral cancer is well established, however there is a wide variation in the incidence of tobacco - related oral cancer in the literature, ranging between 70-90%. Our data shows that only half of the patients with oral cancer have any history of tobacco exposure (smoking, chewing or others). Younger patients with oral cancer (
From a prospectively maintained database of patients treated for oral cancer in our institution, we extracted details for 643 patients of oral cavity squamous cell carcinoma. We divided these patients into four groups, younger patients (
The percentage of those with tobacco exposure was comparable in both age groups. Tobacco exposure correlated with tumour thickness (p = 0.001), perineural invasion (p = 0.002), lymphovascular invasion (p = 0.004) and local recurrence (p = 0.006) in the younger patients but not in the older patients. In younger patients, those with tobacco exposure also had a positive trend for poorer differentiation (p = 0.07) and extranodal extension (p = 0.06). Patients
Younger patients with exposure to tobacco have worse clinical outcome, possibly as a result of adverse pathological features like perineural invasion and lymphovascular invasion. Whether this relationship is due to an underlying immune mechanism requires further study. Younger tobacco users with oral cancer are more likely to have a poor prognosis.
Clinical trial identification
This is not a clinical trial
Legal entity responsible for the study
Amrita Institute of Medical Sciences, Kochi, India
All authors have declared no conflicts of interest.