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Prognostic value of a mandibular canal staging system for primary lesions in patients with lower gingival squamous cell carcinoma: a multicenter, retrospective study

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Abstract

Background

The Union for International Cancer Control and American Joint Committee on Cancer tumor staging system is used globally for treatment planning. As it may be insufficient for tumor staging of lower gingival carcinomas, we proposed the mandibular canal tumor staging system. In this study, we aimed to compare the two systems for such tumor staging and to identify prognostic markers.

Methods

This multicenter, retrospective study included patients with lower gingival squamous cell carcinoma who underwent radical surgery during 2001–2018. We compared survival rates (Kaplan–Meier estimator) and patient stratification according to the two systems.

Results

The proposed system yielded more balanced patient stratification than the existing system. Progression in the tumor grade according to the proposed system was associated with a poorer prognosis. The 5-year overall and disease-specific survival rates for the entire cohort were 74.9% and 81.8%, respectively. Independent factors affecting overall survival were tumor stage according to the proposed system, excision margins, and number of positive nodes, whereas those affecting disease-specific survival were excision margins and number of positive nodes.

Conclusions

Subsite-specific tumor classification should be used for patients with oral cancer, and our results suggest that mandibular canal tumor classification may be effective for patients with lower gingival carcinoma.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available owing to privacy or ethical restrictions.

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Acknowledgements

We would like to thank the following individuals for their cooperation in data acquisition: Dr. Yohei Nakayama and Dr. Yasushi Nakamura from the Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University. We were assisted in the statistical analysis by a statistician, Dr. Hiroyuki Kurakami of the Institute for Clinical and Translational Science, Nara Medical University. We did not receive any funding for this study, including those of an institutional or departmental nature.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan

    Nobuhiro Yamakawa & Tadaaki Kirita

  2. Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Masaya Okura & Yusuke Yokota

  3. Oral and Maxillofacial Surgery, Saiseikai Matsusaka General Hospital, 1-15-6 Asahi-Cho, Matsusaka, Mie, 515-8557, Japan

    Masaya Okura

  4. Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan

    Takumi Hasegawa & Masaya Akashi

  5. Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan

    Mitsunobu Otsuru & Masahiro Umeda

  6. Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan

    Hironori Sakai & Hiroshi Kurita

  7. Oral and Maxillofacial Surgery, Oita Red Cross Hospital, 3-2-37 Chiyomachi, Oita, 870-0033, Japan

    Eiji Hirai

  8. Department of Clinical Oral Oncology, National Hospital Organisation Hokkaido Cancer Center, 3-54 Kikusui 4-2, Shiroisi-Ku, Sapporo, Hokkaido, 003-0804, Japan

    Shin Rin & Michihiro Ueda

  9. Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan

    Shin-ichi Yamada

  10. Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami Ward, Hiroshima, 734-8553, Japan

    Souichi Yanamoto

Authors
  1. Nobuhiro Yamakawa
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  2. Masaya Okura
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  3. Takumi Hasegawa
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  4. Mitsunobu Otsuru
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  5. Hironori Sakai
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  6. Eiji Hirai
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  7. Shin Rin
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  8. Shin-ichi Yamada
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  9. Souichi Yanamoto
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  10. Yusuke Yokota
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  11. Masahiro Umeda
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  12. Hiroshi Kurita
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  13. Michihiro Ueda
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  14. Masaya Akashi
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  15. Tadaaki Kirita
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Consortia

Japan Oral Oncology Group (JOOG)

Contributions

Study concepts: MOkura. Study design: NYamakawa, MOkura. Data acquisition: MOkura, THasegawa, MOtsuru, HSakai, EHirai, SRin, YYokota, SYamada, and SYanamoto. Quality control of data and algorithms: MOkura, MUmeda, HKurita, MUeda, MAkashi, and TKirita. Data analysis and interpretation: NYamakawa, MOkura, and TKirita. Statistical analysis: NYamakawa. Manuscript preparation: NYamakawa. Manuscript editing: All authors. Manuscript review: All authors.

Corresponding author

Correspondence to Nobuhiro Yamakawa.

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Conflict of interest

None to declare. The authors have full control of all primary data and agree to allow the journal to review their data if requested.

Ethics approval

This study was approved by the Independent Ethics Committee of Nara Medical University (approval number: 3578).

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Yamakawa, N., Okura, M., Hasegawa, T. et al. Prognostic value of a mandibular canal staging system for primary lesions in patients with lower gingival squamous cell carcinoma: a multicenter, retrospective study. Int J Clin Oncol (2024). https://doi.org/10.1007/s10147-024-02542-y

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  • DOI: https://doi.org/10.1007/s10147-024-02542-y

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