Clinicopathological study of upper gingival carcinoma

• Published in: JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY Vol. 21; no. 2; pp. 157 - 162
• Main Authors: Asano, Rie, Iida, Yoshiyuki, Nakamura, Satoshi, Onitsuka, Tetsuro, Kamijo, Tomoyuki
• Format: Journal Article
• Language: Japanese
• Published: JAPAN SOCIETY FOR HEAD AND NECK SURGERY 2011
• Subjects: Oral-floor carcinoma; Prognostic factor; Surgery; Tumor thickness
• ISSN: 1349-581X; 1884-474X; 1884-474X
• DOI: 10.5106/jjshns.21.157

We investigated 35 patients (30 male, 5 female) with oral-floor carcinoma for prognostic factors. The subjects were patients with an average age of 61.8 (range 38-78) years who had been operated and managed at our hospital from September 2002 to December 2007. The cancer stage was classified as Stage 0 in 1 patient, Stage I in 10 patients, Stage II in 8 patients, III in 2 patients, and Stage IVa in 14 patients. We chose the following surgical procedures for the cancer: 1) Superficial-layer dissection of the oral floor, 2) deep-layer dissection, and 3) pull-through dissection. These procedures were used in 6, 11 and 18 patients, respectively. The overall 3-year survival rate was 74.2% and the disease specific 3-year survival rate was 82.6%. There were no significant prognostic factors among the local factors, such as mandibular bone invasion and the surgical procedure employed. Thus, the presence/absence of mandibular bone invasion does not seem to contribute directly to the prognosis. Therefore, the dissection should be carried out based on the result of appropriate preoperative assessment. A trend towards poor prognosis was recognized in patients who had five or more pathological lymph-node metastases. In contrast, there was no clear correlation between the N Stage and the prognosis. A significant trend toward nodal involvement was observed in patients with submucosal invasion up to a depth ≥ 10 mm. In conclusion, it is important for surgical treatment of oral-floor carcinoma to assess deep invasion correctly and to determine adequate neck dissection.