Carcinoma of the tongue in young patients

Carcinoma of the tongue is the second most common malignancy of the oral cavity, predominantly affecting males in the sixth and seventh decades of life. The risk factors for this disease (primarily tobacco and ethanol abuse) are well documented in the literature. The current five-year survival for a T1 lesion without nodal involvement is approximately 80%. Over the past 10 years a group of younger patients (less than 40 years) has been identified. Eleven of these patients presenting to the London Regional Cancer Centre since 1976 are reviewed with respect to stage at diagnosis, known risk factors, and the outcome of treatment. Comparison is then made with a similar group of older (over 40 years) patients. The previously identified risk factors, and the male/female ratio are quite different from the older patients. This younger group would appear to have a biologically more aggressive tumor than the stage (TNM) at presentation would suggest. They require more complex treatment, frequently requiring major resections plus radiotherapy for what appears to be early disease. The role for more aggressive initial therapy must be considered.