Clinicopathological Characteristics and Survival in Young Adults With Oral Squamous Cell Carcinoma: A Retrospective Comparative Cohort Study

Background The incidence of oral squamous cell carcinoma (OSCC) in younger patients is increasing, but it remains unclear whether early‐onset disease differs prognostically from OSCC in older individuals. Methods We retrospectively compared 68 patients aged ≤ 45 years and 616 patients aged > 45 years with primary surgically treated OSCC (2009–2021). Clinicopathological variables were reassessed according to the eighth edition of the UICC/AJCC TNM classification. Overall survival (OS) and locoregional recurrence‐free survival (LRRFS) were analyzed using Kaplan–Meier and log‐rank methods; cohorts were compared using chi‐square and Mann–Whitney U tests. Results Five‐year OS and LRRFS were similar in younger and older patients (77%/74% vs. 74%/74%). In both cohorts, outcomes were significantly associated with tumor stage, nodal status, resection margins, lymph node ratio (LNR), and histopathological risk factors including perineural and lymphovascular invasion. Among node‐positive patients, higher LNR was associated with worse OS in both age groups, while older patients showed significantly higher LNR values despite comparable lymph node metastasis rates. Tumor localization differed significantly: tongue carcinomas were more frequent in younger patients, whereas floor‐of‐mouth and mandibular tumors predominated in older individuals. Conclusion In surgically treated OSCC, prognosis appears to be determined primarily by tumor‐related factors rather than patient age.