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JOMS study: Survival rates decrease each year mouth cancer goes undiagnosed

May 02, 2019

ROSEMONT, Ill. – Survival rates decline every year for patients with undiagnosed gum cancer known as primary gingival squamous cell carcinoma, according to a new study.

For each year diagnosis is delayed, the risk of disease-specific death rises by 2.5 percent, according to the study published in the May issue of the Journal of Oral and Maxillofacial Surgery – the official journal of the American Association of Oral and Maxillofacial Surgeons (AAOMS). In addition, with each 1-millimeter increase in tumor size, the risk of disease-specific death rose by 2.2 percent.

The study analyzed data of 4,345 U.S. patients diagnosed with the gum cancer from 1973 to 2015 to determine characteristics and survival outcomes of the cancer. Most cancerous lesions were found in older white patients and almost equally between men and women. Researchers noted gum cancer can be challenging to diagnose because most lesions found in the gingiva (gum tissue) are noncancerous.

Survival rates for patients also decline with age at diagnosis, as the cancer spreads into bone or lymph nodes, and in those who do not have surgery, according to the study.

The five-year, disease-specific survival rate – which measures the percentage of patients who did not die of the condition within the set period of time – was 71 percent. By comparison, the five-year, disease-specific survival rate was 69 percent for those diagnosed at age 70 or older, 57 percent for those whose cancer spread into adjacent bone, 49 percent for those who did not undergo surgery and 44 percent for those whose cancer spread to at least one lymph node.

The gingiva is the third most common location for oral squamous cell carcinoma after the tongue and floor of the mouth, yet no previous studies have evaluated the characteristics and survival outcomes of this cancer in the gums, researchers wrote.

“Future studies should evaluate disease-free survival and define the role of adjuvant therapies in reducing the mortality rate,” researchers said.

The authors of “Which Clinicopathologic Factors Affect the Prognosis of Gingival Squamous Cell Carcinoma: A Population Analysis of 4,345 cases” are Kevin C. Lee, DDS, Division of Oral and Maxillofacial Surgery, NewYork-Presbyterian/Columbia University Irving Medical Center; Sung-Kiang Chuang, DMD, MD, DMSc, Department of Oral and Maxillofacial Surgery, University of Pennsylvania; and Elizabeth M. Philipone, DMD, and Scott M. Peters, DDS, Division of Oral and Maxillofacial Pathology, NewYork-Presbyterian/Columbia University Irving Medical Center.

The full article can be accessed at JOMS.org/article/S0278-2391(19)30010-2/fulltext.

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The Journal of Oral and Maxillofacial Surgery is published by the American Association of Oral and Maxillofacial Surgeons to present to the dental and medical communities comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral and head and neck cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment, and modern therapeutic drugs and devices.