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Epidermoid carcinoma of the gum: A 20‐year survey

Between 1942 and 1961, 606 patients with epidermoid cancer of the gum were studied. Three quarters were men, and 95% of them smoked; one half of the women did not. Sixty‐three per cent had clinically localized disease, and 51% had primary lesions under 3 cm in diameter. Absolute survival rose from 27% in 1946 to 50% in 1961. Determinate survival rose from 35% to 64%. Localized cancer of the gum under 3 cm in diameter was cured in over 80% of patients. Lesions accompanied by only submandibular lymph node metastases were cured in 80%. If nodal metastases occurred in the jugular chain, 38% were salvaged. Gum cancer over 5 cm had a poor outlook, and if accompanied by jugular node metastases was uniformly fatal. This report demonstrates that currently gum cancer presents with smaller diameter primary lesions and higher and more favorable lymph node metastases to account for the increasing survival. Thus the changing patterns of disease produced the improving survival. Categories of patients in whom adjunctive measures and elective neck dissections should be strongly considered are outlined.