Metastatic tumours to the oral cavity: a survival study with a special focus on gingival metastases.
OBJECTIVE
To describe survival from oral metastases, particularly gingival metastases, and to identify clinical prognostic variables.


METHODS
A series of 39 patients were studied, analysing age, gender, primary tumour site, oral metastases site and histological type.


RESULTS
Mean age: 62.3+/-9.2 years, with similar prevalence by gender. The most frequent sites for primary tumours were the kidney (20.5%), lung (20.5%) and breast (20.5%). Gingival metastases represented 63.6% of all oral soft tissue metastases (7/11). The average time between primary tumour diagnosis and appearance of the gingival metastases was 9.7+/-13.4 months. The median survival time since gingival metastases appearance was 5.2 months [95% confidence interval (CI)=0-13.6]; no statistically significant difference with other oral locations was found by the Kaplan-Meier curves (log rank: 0.29; p>0.05). Oral metastases involving the gingiva were more frequently found in the maxilla (85.7%versus 14.3%), whereas intra-osseous metastatic tumours were more frequent in the mandible (77.8%versus 22.2%; p<0.05; odds ratio=21; 95% CI=2.0-210.1). None of the variables considered had a prognostic value as indicated by the Kaplan-Meier test.


CONCLUSIONS
The data in this paper show that 25% (and in other studies up to 37%) of oral metastases came from unknown primary tumours; thus a biopsy with histopathologic analysis is mandatory for every patient with a gingival mass.


CONCLUSIONS
This study reinforces the significance of gingival metastases as a poor prognosis indicator. Dental practitioners should suspect that gingival masses mimicking benign or inflammatory lesions may represent a sign of underlying malignant tumours.
Seoane
Juan
J
Department of Stomatology, School of Medicine and Dentistry, University of Santiago de Compostela, Spain.
Van der Waal
Isaäc
I
Van der Waal
Rutger I F
RI
Cameselle-Teijeiro
José
J
Antón
Iosu
I
Tardio
Antoni
A
Alcázar-Otero
Juan J
JJ
Varela-Centelles
Pablo
P
Diz
Pedro
P
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005887:Gingival Neoplasms / Q000401:mortality / Q000556:secondary*; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008339:Mandibular Neoplasms / Q000556:secondary; D008441:Maxillary Neoplasms / Q000556:secondary; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000556:secondary*; D009382:Neoplasms, Unknown Primary / Q000473:pathology; D009426:Netherlands / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D013997:Time Factors