A clinico-statistical study of maxillary gingival carcinomas

This paper presents the results of a clinico-statistical study of maxillary gingival carcinoma. From 1975 to 1987, 51 cases of maxillary gingival carcinoma were diagnosed and 46 cases were treated in our clinic. T2 and T4 size carcinomas were predominant in T-classification. Many T4 size carcinomas were shown to be tumorous types by clinical findings and bone resorption invasive types by radiological findings. Gingival carcinomas showing erosive-type bone resorption by radiological findings included many with type 1, type 2, and type 3 criteria based on the mode of invasion according to histopathological analysis. The invasive type tends to show type 3, type 4C and type 4D criteia in the mode of invasion. Eighteen cases were treated by surgery alone and the 5-year cummulative survival rate of this group was 77%. Thirteen cases were treated with a combination of surgery, radiotherapy and regional intra-arterial infusion chemotherapy, and the survival rate of this group was 70.1%. The five year cummulative survival rate of all the treated cases was 60.9%. Stage I & II tumors were treated mainly by surgery alone while Stage III & IV tumors were mostly treated by combined therapy. Primary tumor control rate with initial therapy was 71.7%. Overall tumor control rate was 63%. Thirteen cases showed local recurrence in the primary lesion after the initial therapy. Initial regional lymph node metastases were found in 10.9% of the cases, and secondary regional lymph node metastases arisen from initial N0 cases were observed in 14.6%. Secondary distant metastases during clinical course were found in 17.4%. A distinctive feature of maxillary gingival carcinoma was that the interval of tumor recurrence was rather long and distant metastasis was often seen in spite of good local and regional tumor control.