Influence of preoperative dental procedures on the prognosis of patients with squamous cell carcinoma of the gingiva

Our aim was to investigate the prognosis of patients with squamous cell carcinoma (SCC) of the gingiva who had preoperative dental operations. We studied 102 patients who were being operated on for SCC of the gingiva with special reference to the effects of preoperative dental operations on the prognosis. Twenty-six patients had dental procedures such as tooth extraction, or incision, or curettage before they visited our hospital, while the remaining 76 had no such interventions. The percentage of patients with advanced T stage disease (T3 or T4) was higher among those who had interventions (17/26, 65%) than among those who had not (35/76, 46%). The difference was not significant. Histopathologically invaded nodes were detected in half the patients in the intervention group (13/26), while they were found in only 18/76 (24%) of those in the no intervention group (p < 0.02). The incidence of nodal metastases with extranodal spread was significantly higher in the intervention group than in the no intervention group (p < 0.05), and those in the intervention group were more likely to develop distant metastases than those in the other group (p < 0.001). The 5-year survival in the two groups was 65% and 92%, respectively (p < 0.01). Preoperative dental operations such as tooth extraction, incision, or curettage possibly lead to regional and distant metastases and therefore a poor prognosis in patients with SCC of the gingiva.