Abstract：
The aim of this study was to characterize the clinicopathological features and prognostic factors of T1/2 size (<4 cm) gingival squamous cell carcinoma (SCC) and to verify the impact of bone invasion. This was a single-centre, retrospective cohort study involving 206 patients with gingival SCC (maxilla or mandible), treated between 2000 and 2020. The patients were divided into three subgroups based on tumour size and bone invasion. The 5-year overall survival (OS) and disease-free survival (DFS) were 80.6% and 67.6%, respectively. Histological differentiation, advanced T stage, positive resection margin, bone invasion, and postoperative adjuvant therapy were associated with a poor prognosis (P < 0.05). Multivariate Cox analysis indicated that only histological differentiation (hazard ratio (HR) 2.68, P = 0.007) and bone invasion (HR 2.08, P = 0.036) were significantly associated with DFS. Bone invasion was observed in 145 (70.4%) patients, of whom 43 (20.9%) had a T1/2 size tumour. The subgroup with bone invasion and T1/2 size showed significantly worse OS and DFS when compared to the subgroup without bone invasion and similar or worse survival when compared to the subgroup with bone invasion and T3/T4 size. Histological differentiation and bone invasion were poor prognostic factors for gingival SCC, even in cases with small-sized tumours. For suspected bone invasion in small-sized tumours, an adequate bone margin is necessary and postoperative adjunctive therapy needs to be considered.
摘要：
这项研究的目的是描述T1/2大小（<4cm）牙龈鳞状细胞癌（SCC）的临床病理特征和预后因素，并验证骨侵袭的影响。这是一个单一的中心，回顾性队列研究涉及206例牙龈SCC（上颌骨或下颌骨），在2000年至2020年之间接受治疗。根据肿瘤大小和骨侵犯将患者分为三个亚组。5年总生存率(OS)和无病生存率(DFS)分别为80.6%和67.6%,分别。组织学分化，先进的T级，切缘阳性,骨侵入,术后辅助治疗与不良预后相关(P<0.05)。多因素Cox分析表明，仅组织学分化（风险比（HR）2.68，P=0.007）和骨侵犯（HR2.08，P=0.036）与DFS显着相关。在145例（70.4%）患者中观察到骨侵犯，其中43人（20.9%）患有T1/2大小的肿瘤。与没有骨侵袭的亚组相比，具有骨侵袭和T1/2大小的亚组显示出明显更差的OS和DFS，与具有骨侵袭和T3/T4大小的亚组相比，存活率相似或更差。组织学分化和骨侵袭是牙龈SCC的不良预后因素，即使是小肿瘤。对于小型肿瘤中可疑的骨侵犯，足够的骨缘是必要的，需要考虑术后辅助治疗。
