Publication date: Available online 15 January 2019
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Kevin C. Lee, Sung-Kiang Chuang, Elizabeth M. Philipone, Scott M. Peters
Abstract
Background
The purpose of this study was to present the characteristics and survival outcomes of primary gingival SCC.
Methods
This is a retrospective cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) tumor registry. Patients diagnosed with a primary gingival SCC were included in the analyses. Predictors variables were chosen from baseline demographic and tumor characteristics. The outcome of interest was survival, and Kaplan–Meier analyses were used to estimate rates of overall (OS) and disease-specific survival (DSS). Cox proportional hazards regression models were used for multivariate analyses.
Results
In total, there were 4,345 patients (mean age: 70.2 years) identified with a primary gingival SCC. There was a significantly positive association between T stage and both nodal and distant metastases. Two, 5, and 10-year OS rates were 53.0, 34.1, and 16.0%, while DSS rates were 78.2, 70.7, and 62.2% respectively. Multivariate Cox proportional hazards regression revealed that independent predictors of overall and disease-specific mortality were older age, T4 stage, nodal disease, and the absence of surgery. Histologic grade and tumor size were significantly associated with only DSS. Race, gingival location (maxillary vs mandibular), verrucous histology, and the presence of distant metastases did not significantly affect survival when all other predictors were controlled for.
Conclusions
Older age at diagnosis, bony infiltration, nodal disease, and the absence of surgery were each individually associated with lower OS and DSS. Because of low nodal disease rates, both T1 N0 M0 lesions and verrucous subtypes may be candidates for neck observation.
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