(A579) More Than Just a Number: Age at Diagnosis and Survival Outcomes in Oral Cavity SCC

Monday, October 13, 2025

12:00 PM - 1:00 PM EDT

Location: OTO EXPO, Posters

Presenting Author(s)

Nicole K. Rud, BA

Medical Student
Creighton University School of Medicine
Omaha, NE, United States

Co-Author(s)

Claire S. Malhotra, BS

M4
Creighton University School of Medicine
Omaha, Nebraska, United States

Co-Author(s)

Andrew J. Holcomb, MD

Head and neck surgeon
Nebraska Methodist Hospital
Elkhorn, NE, United States
Andrew Coughlin, MD

Associate Professor
Nebraska Methodist Hospital Estabrook Cancer Center
OMAHA, Nebraska, United States
AO

Angela Osmolak, MD

Methodist Estabrook Cancer Center, Omaha, Nebraska, United States
RL

Robert Lindau, MD

Methodist Estabrook Cancer Center, Omaha, Nebraska, United States
Oleg Militsakh, MD

Professor of Surgery
Estabrook Cancer Center - Nebraska Methodist Hospital
Omaha, NE, United States
Apar Kishor Ganti, MD

Professor of Internal Medicine
University of Nebraska Medical Center, Omaha, Nebraska
OMAHA, NE, United States
Harlan R. Sayles, PhD

Assistant Professor
College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
Omaha, NE, United States
WL

William Lydiatt, MD

Methodist Estabrook Cancer Center, Omaha, Nebraska, United States

Senior Author(s)

Aru Panwar, MD FACS

Head and Neck Surgical Oncology
Methodist Estabrook Cancer Center
Omaha, Nebraska, United States

Disclosure(s):

Claire S. Malhotra, BS: No relevant relationships to disclose.

Andrew Coughlin, MD: No relevant relationships to disclose.

Oleg Militsakh, MD: No relevant relationships to disclose.

Harlan R. Sayles, PhD: No relevant relationships to disclose.

Aru Panwar, MD FACS: No relevant relationships to disclose.

Introduction: Data conflict on whether age at diagnosis is associated with oncologic outcomes following oral squamous cell carcinoma (OCSCC). This study explores the association between age at diagnosis and Overall (OS), Disease-Free (DFS), Locoregional Recurrence-Free (LRRFS), and Distant Recurrence-Free (DRFS) survival.

Methods: Retrospective analysis of 249 patients receiving surgery +/- adjuvant radiotherapy with/without chemotherapy for new-onset OCSCC. Baseline characteristics, comorbidities, tumor histopathology, staging data, extent of surgery, radiotherapy dose, and receipt of chemotherapy were evaluated. Fisher’s exact and Kruskal-Wallis tests were used to compare age across treatment groups and restricted cubic splines for evaluating the shape of association between age at diagnosis and the log hazard ratios for each outcome suggesting a piecewise linear approach, dividing age at diagnosis into three segments (18-44, 45-60, >60 years). Cox proportional hazard regression models were used to evaluate the association between age at diagnosis and outcome risk.

Results: Of 249 patients, 132 (53%) were diagnosed at age >60, 85 (34%) at age 45-60, and 32 (13%) at age 18-44. There were no differences between groups’ demographics, stage at presentation, margin positivity, or adverse pathologic features (all p>0.05). Younger patients were less likely to be smokers (p < 0.001). Adjusted association between age at diagnosis and outcomes, depicted via restricted cubic spline plots, suggest inflection points at ages 45 and 60. Diagnosis at ages 18-44 and 45-60 did not have independent association with hazard for adverse survival outcomes. Older patients (>60 years) experienced inferior OS (HR 1.06, 95%CI 1.02-1.09), DFS (1.04, 95%CI 1.01-1.07), LRRFS (1.07, 95% CI 1.03-1.10), and DMFS (1.06, 95%CI 1.03-1.10).

Conclusions: Association of age and oncologic outcomes following OCSCC is complex, and poorly suited to analyses employing dichotomization of age. Age at OCSCC diagnosis may be significantly associated with OS, DFS, LRRFS, and DMFS for older patients (>60 years).