Niu L X, Feng Z E, Wang D C, Zhang J Y, Sun Z P, Guo C B
Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Peking University, Beijing, China.
Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Capital Medical University, Beijing, China.
Int J Oral Maxillofac Surg. 2017 Feb;46(2):137-143. doi: 10.1016/j.ijom.2016.09.014. Epub 2016 Oct 28.
The mandibular gingiva is the second most common site of oral cavity squamous cell carcinoma. This retrospective study was designed to determine the clinicopathological features of squamous cell carcinoma of the mandibular gingiva (MGSCC) and to establish a new risk model to predict overall survival. The study included 207 patients with primary MGSCC from January 2000 to September 2009. The medical charts were reviewed and data related to clinical characteristics, treatment provided, histopathological analysis, and follow-up were recorded. All patients underwent surgery as the first-line therapy; follow-up ranged from 1 to 171 months (median 63 months). Clinical characteristics and pathological outcomes were analyzed with respect to the 5-year overall survival rate. A survival risk model was established, and patients were classified into low-, moderate-, and high-risk groups based on the prognostic index designed in this study. The 5-year overall survival rates for the low-, moderate-, and high-risk groups were 92.3%, 76.9%, and 34.2%, respectively. Pathological node metastasis, perineural invasion, and extracapsular spread were the most significant predictive factors for 5-year overall survival. MGSCC is not aggressive, and the survival outcomes of MGSCC are better than those of squamous cell carcinoma (SCC) at other sites. It is suggested that patients with T2-T4 tumours undergo elective neck dissection and those with T1 tumours be followed up without addressing the neck.
下颌牙龈是口腔鳞状细胞癌的第二大常见发病部位。本回顾性研究旨在确定下颌牙龈鳞状细胞癌（MGSCC）的临床病理特征，并建立一种新的风险模型以预测总生存期。该研究纳入了2000年1月至2009年9月期间的207例原发性MGSCC患者。查阅了病历，并记录了与临床特征、所提供的治疗、组织病理学分析及随访相关的数据。所有患者均接受手术作为一线治疗；随访时间为1至171个月（中位时间63个月）。针对5年总生存率分析了临床特征和病理结果。建立了生存风险模型，并根据本研究设计的预后指数将患者分为低风险、中风险和高风险组。低风险、中风险和高风险组的5年总生存率分别为92.3%、76.9%和34.2%。病理淋巴结转移、神经周围侵犯和包膜外扩散是5年总生存率的最显著预测因素。MGSCC侵袭性不强，其生存结果优于其他部位的鳞状细胞癌（SCC）。建议T2 - T4期肿瘤患者接受选择性颈清扫术，T1期肿瘤患者进行随访而不处理颈部问题。
