Outcome of squamous cell carcinoma of the gingiva: a follow-up study of 83 cases

Abstract

Background: Squamous cell carcinomas of the gingiva are relatively rare tumours. Standard treatment is based on surgery and radiotherapy. The extent of bone involvement affects mandibulectary indications. Purpose: A retrospective review of squamous cell carcinomas of the gingiva was performed to evaluate the incidence of mandibular or maxillary bone involvement. Indications for marginal and segmental bone resections are specified. Material: From 1985 to 1996, 83 patients with squamous cell carcinoma of the gingiva were treated at the Department of Surgery (Institut Bergonié, Bordeaux, France) and at the Department of Maxillofacial and Plastic Surgery (Centre Hospitalier Universitaire, Bordeaux, France). Forty-three underwent surgery plus postoperative radiotherapy. Twenty-two had flap reconstructions. Clinical evaluation and panorex róntgenography were the means used to evaluate bony invasion and to decide on the extent of bone resection. Methods: A retrospective review of 83 consecutive patients was performed. This series is unusual in its homogeneity: surgery was performed by only two individuals and the radiotherapy was the responsibility of just two physicians. Outcome was calculated using the Kaplan-Meier method. Results: Primary local control was achieved in 72 patients (87%). Overall survival and rate of recurrence were comparable to those of other squamous cell carcinomas of the oral cavity and oropharynx. Conclusion: Surgical resection continues to be the mainstay of treatment and this study tends to confirm the validity of modified neck dissection and marginal bone resection in suitably selected patients.