Metastatic Potential of Oral Squamous Cell Carcinoma in Young Adults: A Comparative Analysis

Abstract The incidence of oral squamous cell carcinoma (OSCC) is rising among young adults, a demographic historically considered at low risk. Conflicting literature exists regarding the biological aggressiveness of the disease in this age group compared to older patients. This study aims to compare the frequency of cervical nodal metastasis between young adults (20 to 30 years) and older age group of people in Pakistan. A total of 257 biopsy-proven OSCC patients were included. Patients were categorized into three age groups: 20 to 30 years classified as young adults; 31 to 60 years termed as middle-aged; and 61 to 80 years referred to as elderly in this study. The primary outcome measure was the presence of cervical nodal metastasis. Statistical analysis was performed using the chi-squared test to determine associations between age and metastatic spread, with p-value <0.05 considered significant. Of the 257 patients, 17.5% (n = 45) were young adults. The overall prevalence of cervical nodal metastasis in the study population was 67.3%. In the young adult group, 66.67% (n = 30) presented with nodal metastasis. This rate was statistically comparable to the middle-aged group, which presented with nodal metastasis of 67.86% while the older age group had 66.67%. The analysis revealed no statistically significant difference in metastatic potential across age groups with p-value = 0.723 and histopathological grade showed a significant association with cervical nodal metastasis (p <0.001). Young adults presenting with OSCC in this population exhibit a high burden of cervical nodal metastasis. These findings suggest that OSCC in young adults behaves with considerable aggression, necessitating urgent and aggressive management strategies.