We aimed to characterize clinical and prognostical factors of primary head and neck
squamous cell carcinoma (HNSCC) in 85 young patients (≤39 years, median age: 37 years;
between 2000-2018) in comparison with 140 institutional general HNSCC patients (median
age: 61.5 years). The patient's medical records were collected from the institutional
database. The prevalence of smoking and alcohol consumption (65.8% and 48.1%) in the
young group exceeded the regional population average but was below the institutional
(86.4% and 55%) general HNSCC patient population. Primary tumor sites in the group
of young patients were as follows: oral cavity (56.4%), oropharynx (17.6%), hypopharynx
(11.7%), and larynx (14.1%). Cumulative five-year overall survival was 44.2% in the
young group, but significantly better with early T (T1-2 vs. T3-4: 52.6% vs. 26.7%;
p = 0.0058) and N0 status (N0 vs. N+: 65.2% vs. 32.3%; p = 0.0013). Young age, abstinence,
earlier stage and laryngeal tumor site might predict a better prognosis. The age distribution
and the high prevalence of traditional risk factors among the young patients as well
as the predominance of oral cavity tumor localization suggest that the early onset
of tumor development could be originated from the premature failure of the intrinsic
protective mechanisms.
