Gingival squamous cell carcinoma: diagnostic delay or rapid invasion?

Area of Science:

• Oncology
• Oral Pathology
• Diagnostic Medicine

Background:

• Gingival squamous cell carcinoma (GSCC) shares similarities with periodontal lesions, potentially delaying diagnosis.
• Neoplastic lesions of the gingiva are often identified at advanced stages.

Purpose of the Study:

• To evaluate the total diagnostic time for gingival squamous cell carcinoma (GSCC) compared to other oral tumors.
• To identify factors influencing delayed diagnosis in oral cancer cases.

Main Methods:

• Retrospective analysis of 59 oral cancer cases, including gingival carcinomas.
• Variables assessed: age, gender, smoking, tumor stage, and total diagnostic time (time from patient awareness to diagnosis).
• Statistical analysis using Student t test and chi2 test with 95% CI; median diagnostic time of 1.5 months used as a cutoff.

Main Results:

• No significant difference in time to diagnosis was found between gingival cancers and other oral tumors.
• However, gingival cancers more frequently invaded adjacent structures by diagnosis (p<0.001).
• 75% of gingival carcinomas had a diagnostic time <1.5 months, compared to 50% for tongue and 78% for floor-of-the-mouth carcinomas.

Conclusions:

• Gingival squamous cell carcinoma (GSCC) is associated with advanced stages (T4) at diagnosis due to early invasion of bone.
• The findings underscore the need for earlier referral and diagnosis of suspected gingival lesions.
• Improved diagnostic strategies are essential to prevent advanced staging of oral squamous cell carcinoma (OSCC).