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Abstract：
While evidence suggests an increasing incidence of tongue cancer in young adults, published findings regarding the prognostic role of age at diagnosis are inconsistent. We performed a meta-analysis of the literature to highlight key points that might help in understanding the association between age of oral tongue cancer patients at diagnosis and their prognosis. According to age at diagnosis, a systematic literature review of all published cohort studies assessing the recurrence risks and mortality associated with tongue cancer was conducted. We compared the risk estimates between patients aged >45 years and those aged <45 years at diagnosis. Random-effects models were used to calculate summary relative risk estimates (SRRs) according to different clinical outcomes and sources of between-study heterogeneity (I2 ) and bias. We included 31 independent cohort studies published between 1989 and 2019; these studies included a total of 28,288 patients. When risk estimations were not adjusted for confounders, no significant association was found between age at diagnosis and overall survival (OS). Conversely, after adjustment for confounders, older age at diagnosis was associated with a significantly increased risk of mortality. The difference between SRRs for adjusted and unadjusted estimates was significant (p < 0.01). Younger patients had a significantly higher risk of local recurrence. Younger patients with oral tongue cancer have better OS but a greater risk of recurrence than older patients. These findings should be validated in a large prospective cohort study which considers all confounders and prognostic factors.
摘要：
虽然有证据表明年轻人舌癌的发病率增加，已发表的关于年龄在诊断时对预后的作用的研究结果不一致.我们对文献进行了荟萃分析，以强调可能有助于理解口腔舌癌患者在诊断时的年龄与其预后之间的关联的关键点。根据诊断时的年龄，我们对所有已发表的评估舌癌复发风险和死亡率的队列研究进行了系统文献综述.我们比较了年龄>45岁和诊断时年龄<45岁的患者的风险估计值。根据不同的临床结果以及研究间异质性（I2）和偏倚的来源，使用随机效应模型来计算汇总相对风险估计值（SRR）。我们纳入了1989年至2019年发表的31项独立队列研究；这些研究共纳入28,288例患者。当风险估计没有针对混杂因素进行调整时，在诊断时年龄和总生存期(OS)之间未发现显著关联.相反，在对混杂因素进行调整后，诊断时年龄较大与死亡风险显著增加相关.调整后和未调整后的估计的SRR之间的差异是显著的(p<0.01)。年轻患者局部复发的风险明显较高。与老年患者相比，年轻的口腔舌癌患者有更好的OS，但复发风险更大。这些发现应在考虑所有混杂因素和预后因素的大型前瞻性队列研究中得到验证。
