title: Prognosis for gingival carcinomas with a delayed diagnosis after dental extraction.
abstract: OBJECTIVE
  In gingival squamous cell carcinoma (GSCC), the association between survival and previous dental extraction (DE) is controversial. The purpose of this study was to investigate the prognosis for patients in whom GSCC was detected after DE was performed.
  
  
  METHODS
  DE for GSCC tumor symptoms was performed in 19 patients before diagnosis (DE group) and not in 58 patients (non-DE group). The clinical features, characteristics, and prognosis were evaluated statistically between the 2 groups.
  
  
  RESULTS
  The interval from DE to the first hospital visit was 1.1 to 97 weeks (median, 7.3 weeks). There was no significant difference in tumor status, node status, local recurrence, pathologically positive lymph nodes, or distant metastasis between the DE and non-DE groups. Bone invasion was observed radiographically in 6 patients with mandibular GSCC in the DE group (100%) and 13 in the non-DE group (68.4%). There was a significant difference in bone invasion between the DE and non-DE groups (P < .01). Segmental mandibulectomy was performed in 11 patients (84.6%) in the DE group and 21 patients (61.8%) in the non-DE group. Extent of resection tended to be larger for the DE group. The 5-year overall survival rate was 84.6% for the DE group and 65.8% for patients with mandibular GSCC in the non-DE group. For maxillary GSCC, the survival rates differed significantly between groups (33.3% in DE group and 73.7% in non-DE group).
  
  
  CONCLUSIONS
  For mandibular GSCC, the resection field was appropriate for the extent of bone invasion after DE and the prognosis was similar to that in the non-DE group. For maxillary GSCC, a broad surgical field is suggested because of the potential for rapid spread in cancellous bony trabeculae.
authors.affiliation: Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. Electronic address: y-kenji@live.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamagata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.forename: Kojiro
authors.initials: K
authors.lastname: Onizawa
authors.forename: Masanobu
authors.initials: M
authors.lastname: Yamatoji
authors.forename: Toru
authors.initials: T
authors.lastname: Yanagawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Bukawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D016009:Chi-Square Distribution; D057210:Delayed Diagnosis; D005260:Female; D005887:Gingival Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007573:Jaw Neoplasms / Q000556:secondary*; D053208:Kaplan-Meier Estimate; D008297:Male; D008334:Mandible / Q000601:surgery; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014081:Tooth Extraction