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Squamous carcinoma of the gums
1Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
American Journal of Surgery
|October 1, 1988
Summary
Squamous cell carcinoma of the gums remains challenging, with surgery as the primary treatment. Advanced stage predicts poorer survival, highlighting the need for early detection in gum cancer care.
Area of Science:
- Oral Oncology
- Surgical Oncology
- Dental Medicine
Background:
- Squamous cell carcinoma (SCC) of the gums is a significant oral malignancy.
- Understanding long-term outcomes and treatment patterns is crucial for improving patient care.
Purpose of the Study:
- To review a 20-year experience with gum SCC in patients undergoing definitive therapy.
- To identify prognostic factors influencing survival rates for this specific cancer.
Main Methods:
- Retrospective review of 347 patients with gum SCC treated over two decades.
- Analysis of treatment choices, focusing on surgical interventions and their modifications.
- Statistical analysis to determine predictors of survival, including univariate and multivariate models.
Main Results:
- The majority of lesions were in the lower gum; most patients were previously untreated.
- Localized tumors (N0) represented 64% of cases.
- Surgery remained the mainstay (97%), with an increase in conservative procedures preserving jaw continuity.
- The 5-year survival rate was 54%.
- Advanced clinical stage, prior dental extraction, bone invasion, and positive margins predicted lower survival on univariate analysis.
- Clinical stage was the sole significant predictor on multivariate analysis.
Conclusions:
- Gum SCC management relies heavily on surgery, with evolving conservative approaches.
- Early clinical stage is a critical factor for favorable survival outcomes.
- Further research is needed to assess the role of radiotherapy in conjunction with surgery.