PROGNOSTIC FACTORS AFFECTING OUTCOME IN LOWER GINGIVAL CARCINOMA

Squamous cell carcinoma of the lower gingiva is a rare lesion that fre quently invades the mandible, To determine the factors that affect loc al disease control and overall survival, a retrospective review of 155 previously untreated patients was performed, Primary lesions larger t han 3 cm (P = .021) and persistently disease-positive surgical margins (P = .027) were found to be associated with decreased local control r ates, Survival was adversely affected by advanced T stage (P = .001), positive initial and final surgical margins (P = .004), mandibular inv asion (P = .014), and cervical metastases (P < .001). Extent of mandib ular resection, tumor extension beyond the lower gingiva, recent denta l extractions in the region of the primary, perineural invasion, and h istologic grade did not affect local control or survival, Although low er gingival carcinoma tends to involve the mandible, our findings indi cate that tumor size is more important than mandibular invasion in pre dicting local disease control, Larger tumors that have a greater prope nsity for local recurrence and poorer survival require a more extensiv e surgical resection.