Impact of age stratification on risk of lymph node metastasis in T1 oral tongue squamous cell carcinomas patients.

Background: The objective of this study is to assess the association between age and lymph nodes metastasis (LNM) in T1 oral tongue squamous cell carcinomas (OTSCC) patients.

Methods: Patients with T1 OTSCC were extracted from the SEER database between 2005 and 2014. Univariate and multivariate logistic regression models were produced to recognize the association between age and risk factors of LNM.

Results: A total of 3535 patients were analyzed. Younger patients more frequently presented with LNM compared to their older peers (P < 0.01). In multivariate analyses, older age was associated with a significantly lower risk of LNM. Compared to patients aged 12-39-years-old, the hazard ratios for patients aged 40-49, 50-59, 60-69, 70-79 and 80-101 years old were 0.999 (95 % confidence interval [CI] 0.684-1.461), 0.863 (95 % CI 0.611-1.219), 0.972 (95 % CI 0.687-1.373), 0.667 (95 % CI 0.452-0.983), and 0.395 (95 % CI 0.241-0.646), respectively. Subgroups analysis shows that the effect of older age was significantly associated with a lower risk of LNM in Caucasian female who harbored moderately differentiated disease.

Conclusion: Our study demonstrates that younger patients with T1 OTSCC had a higher risk of LNM than their old peers, especially for tumors with poor differentiation. More accurate assessments of LNM and prophylactic neck dissection or prophylactic adjuvant radiation therapy to neck will be imperative for reducing recurrence in younger T1 OTSCC.