Cancers of upper gingivobuccal sulcus, hard palate and maxilla: A tertiary care centre study in North India

Abstract

Introduction:Oral cancer is the sixth most common malignancy in the world, and the third most common in southeast Asia. Cancers of the upper gingivo-buccal complex are uncommon and reported infrequently. In this article, we have assessed the clinicopathological features of such cancers and their optimal management.Materials and Methods:We studied 64 patients with cancer of the upper gingivobuccal sulcus (GBS), hard palate, and maxilla seen between February 2009 and 2013 over a span of 4 years.Results:Of the 64 patients studied, 45 were male. The mean age at presentation was 50.59 years (24-80 years). Of the 64, 48 patients (75%) had a history of substance abuse in the form of tobacco chewing, smoking or alcohol. On presentation, 48 of the 64 patients (75%) had T4 disease, eight had T3, six had T2 lesion, one had T1 lesion, and 1 patient had a neck recurrence with distant metastatic disease (Tx). Out of the 64 patients, 31 had clinically palpable neck disease and two patients had distant metastatic disease. Of the 64 patients, 58 had squamous cell carcinoma, two had adenoid cystic carcinoma of the hard palate and one patient each had melanoma, sarcoma, neuroendocrine tumor, and mucoepidermoid carcinoma. Following imaging, 18 patients (28.13%) underwent upfront surgery and six following neoadjuvant chemotherapy. 14 of the 24 patients operated had simultaneous neck dissection. 2 patients with distant metastasis and 1 with cavernous sinus thrombosis received palliative chemotherapy. Out of the 64 patients, the other 24 who were inoperable were referred to radiotherapy.Conclusion:Upper GBS, hard palate and maxilla cancers are uncommon and are diagnosed at an advanced stage due to delay in presentation and ignorance of our population. Surgery offers the best form of treatment. NACT may be tried to downstage the disease in selected patients with borderline operable disease. However, generous margins should be taken post chemotherapy with concomitant neck dissection. Adjuvant radiotherapy is recommended in selected patients after surgery.

A Clinico-Pathological Study of Squamous Cell Carcinoma of Gingivobuccal Complex in Punjab

“…Another similar study was conducted by Kumar V et al, which reported that the most common form of substance abuse in patients with SCC of the gingivobuccal complex was smokeless tobacco (68.75%) followed by smoking (39.58%) and alcohol (12.5%). [20] The study can be compared with a study conducted by Singh et al [18] regarding the most frequent subsite of SCC of the gingivobuccal complex. The study found that the most common site of oral cancer is buccal mucosa and gingivobuccal complex (43.8%) followed by mandibular alveolus (32.1%).…”

Adenoid squamous cell carcinoma of right gingivobuccal sulcus – A rare case report

“…Oral cancer is the sixth most common malignancy in the world and third most common in southeast Asia. 1 The prevalence varies with ethnicity, geographic distribution, and socio-economic differences. The disproportionately higher prevalence of head and neck neoplasm in India may be due to the use of tobacco in various forms.…”

“…The disproportionately higher prevalence of head and neck neoplasm in India may be due to the use of tobacco in various forms. 1,2 The incidence is two to three times more frequent in men than women owing to increased tobacco abuse. 2 Gingivobuccal sulcus, hard palate and maxilla are uncommon and diagnosed at an advanced stage due to delay in presentation.…”

“…2 Gingivobuccal sulcus, hard palate and maxilla are uncommon and diagnosed at an advanced stage due to delay in presentation. 1 These cancers are metastasized rapidly to submandibular and deep cervical lymph nodes and also responsible for death in many cases. In this article we report a rare case of adenoid squamous cell carcinoma of right gingivobuccal sulcus.…”

Cytotoxic Effect of Thymus caramanicus Jalas on Human Oral Epidermoid Carcinoma KB Cells

“…Oral cancer is one of the most common malignancies in the world (1). It is characterized by a high degree of local invasiveness and a high rate of metastases to cervical lymph nodes.…”