CA: A Cancer Journal for Clinicians, Vol 20, 44-47, Copyright
© 1970 by American Cancer Society
Epidermoid Carcinoma of the Gum: A 20-Year Survey
Blake Cady M.D. and
Daniel Catlin M.D.
Six hundred and six cases of epidermoid cancer of the gum were seen by the Head and Neck Service of the Memorial Hospital between 1942 and 1961. Analysis of the clinical manifestations, treatments and results was carried out.
Three quarters of the cases were men, and 95 percent of them smoked tobacco. However, one half of the women did not use tobacco. Dentists were the first practitioners to see over 60 percent of the patient. Sixty-three percent of the patients initially presented with clinically localized disease, and 51 percent of cases had primary lesions less than 3 cm. in diameter. Seventy-nine percent of cases occurred on the lower gum, and 60 percent were posterior to the bicuspid teeth. Nineteen percent of cases had other episodes of intraoral epidermoid cancer at some time. [SEE TABLE IN SOURCE PDF].
Primary treatment was almost entirely surgical after 1946. A total of 199 jaw-neck resections were performed as primary treatment, and 47 such combined resections were performed for patients failing primary therapy elsewhere. Large numbers of local excisions and maxillectomies were also recorded.
Absolute survival for all cases seen rose from 27 percent in the period ending in 1946 to 50 percent in 1961. Determinate survival rose correspondingly from 35 percent to 64 percent. Localized cancer of the gum less than 3 cm. in diameter was treated successfully in over 80 percent of cases. Even such lesions accompanied by only submandibular lymph node metastases were cured in 80 percent of cases. However, if node metastases occurred in the jugular chain, only 38 percent were salvaged. Gum cancer more than 5 cm. in diameter had a poor outlook, and if accompanied by jugular node metastases was uniformly fatal.
This report demonstrates the steady gains made in control of gum cancer and outlines the category of patients in which adjuvant measures and elective neck dissections should be strongly considered.
