Clinical implications of recent exodontia before diagnosis of gingival squamous cell carcinoma: A new classification

Cheng, Ching-An; Chang, Chien-Ming; Hsiao, Ying-Lyung; Chan, Man-Yee; Lee, Chun-Yin; Lee, Li-Tzu; Wong, Yong–Kie

doi:10.1002/hed.23896

Cited by 8 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a previous study, the incidence rate of bone invasion in gingival cancer was high, and bone invasion significantly affected the survival of gingival cancer patients in univariate analyses [4]. However, bone invasion was not found to be an independent prognostic factor when confounding variables such as tumor size were taken into consideration, most likely because of the small sample sizes in studies [2,5].…”

Section: Introductionmentioning

confidence: 90%

“…Invasion to the mandibular bone is therefore one of the common features of lower gingival cancer. The incidence rate of T4 tumors was <10% until the 1990s , compared with 54–70% in recent studies . One possible reason for the increase is the improvement of imaging techniques, including computed tomography and magnetic resonance imaging, to detect bone invasion .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic and staging implications of mandibular canal invasion in lower gingival squamous cell carcinoma

et al. 2016

View full text Add to dashboard Cite

A multi‐institutional study was undertaken to determine whether mandibular canal (MC) invasion and mandibular medullary bone invasion are independent factors in lower gingival squamous cell carcinoma (SCC). A total of 345 patients with lower gingival SCC were retrospectively reviewed. Mandibular bone invasion was categorized into three types; no bone invasion; invasion through cortical bone (medullary); and MC invasion. The overall survival rate and factors affecting local, regional, and distant failures were assessed by Cox proportional hazards regression analysis and Kaplan–Meier estimates. Bone invasion was present in 201 (58%) patients, of whom 107 (31%) had medullary invasion and 94 (27%) had MC invasion. Using the International Union Against Cancer (UICC) staging system and American Joint Committee on Cancer (AJCC) system, 171 (50%) patients were classified as T4a. When the bone invasion criteria were excluded from the UICC/AJCC system definition, 152 T4a tumors were downstaged and reclassified to T1 in 12 (3%), to T2 in 98 (28%), and to T3 in 42 (12%). In Cox multivariate analysis, MC invasion was an independent predictor of overall survival but medullary bone invasion was not. Medullary bone invasion was an independent variable for distant control. The current T staging system has restricted prognostic utility. The authors recommend a modified T staging system, whereby tumors with MC invasion instead of medullary bone invasion are classified as T4a, and tumors are first classified as T1 to T3 based on size and then upstaged by one T classification in the presence of medullary invasion.

show abstract

Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Prognostic and staging implications of mandibular canal invasion in lower gingival squamous cell carcinoma

et al. 2016

View full text Add to dashboard Cite

show abstract

“…As only a thin layer of connective tissue separates the gingival mucosa from the mandible/maxillary bone, bone invasion is the most common pathological adverse feature of gingival cancer. A higher incidence of bone invasion (approximately 60%) has been reported in patients with gingival cancer [8] ; additionally, patients with gingival cancer and bone invasion have poor survival outcomes [8] , [9] . Therefore, postoperative adjuvant treatment is indicated for these patients.…”

Section: Introductionmentioning

confidence: 99%

Postoperative radiotherapy alone is as effective as postoperative chemoradiotherapy in patients with pT4aN0 gingival cancer with negative surgical margins

Fang

Hsieh

Chen

et al. 2023

Clinical and Translational Radiation Oncology

View full text Add to dashboard Cite

“…The UICC/AJCC staging manual classi es LGSCC as stage T4a if it erodes through the cortical bone and invades the bone marrow. However, a much larger proportion of LGSCCs are would accordingly be classi ed as stage T4a than other OSCCs [13][14][15]. We previously demonstrated that medullary bone invasion of LGSCC is not predictive of prognosis; rather, mandibular canal (MC) invasion is [16].…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of a mandibular canal staging system for primary lesions in patients with lower gingival squamous cell carcinoma: a multicenter, retrospective study

Yamakawa,

Okura,

Hasegawa

et al. 2024

Int J Clin Oncol

View full text Add to dashboard Cite

BackgroundThe Union for International Cancer Control and American Joint Committee on Cancer tumor staging system is used globally for treatment planning. As it may be insu cient for tumor staging of lower gingival carcinomas, we proposed the mandibular canal tumor staging system. In this study, we aimed to compare the two systems for such tumor staging and to identify prognostic markers. MethodsThis multicenter, retrospective study included patients with lower gingival squamous cell carcinoma who underwent radical surgery during 2001-2018. We compared survival rates (Kaplan-Meier estimator) and patient strati cation according to the two systems. ResultsThe proposed system yielded more balanced patient strati cation than the existing system. Progression in the tumor grade according to the proposed system was associated with a poorer prognosis. The 5-year overall and disease-speci c survival rates for the entire cohort were 74.9% and 81.8%, respectively. Independent factors affecting overall survival were tumor stage according to the proposed system, excision margins, and number of positive nodes, whereas those affecting disease-speci c survival were excision margins and number of positive nodes. ConclusionsSubsite-speci c tumor classi cation should be used for patients with oral cancer, and our results suggest that mandibular canal tumor classi cation may be effective for patients with lower gingival carcinoma.

show abstract

Clinical implications of recent exodontia before diagnosis of gingival squamous cell carcinoma: A new classification

Abstract: Our proposed classification may help clinicians to identify patients with gingival SCC who present with more advanced disease status.

Cited by 8 publications

References 25 publications

Prognostic and staging implications of mandibular canal invasion in lower gingival squamous cell carcinoma

Prognostic and staging implications of mandibular canal invasion in lower gingival squamous cell carcinoma

Postoperative radiotherapy alone is as effective as postoperative chemoradiotherapy in patients with pT4aN0 gingival cancer with negative surgical margins

Prognostic value of a mandibular canal staging system for primary lesions in patients with lower gingival squamous cell carcinoma: a multicenter, retrospective study

Contact Info

Product

Resources

About