A preliminary comparative study of the prognostic implications of type 2 diabetes mellitus for patients with primary gingival carcinoma treated with surgery and radiation therapy

Purpose: Type 2 diabetes mellitus (DM2) may be a risk factor in determining cancer progression. The aim of this study was to compare the progression of primary gingival cancer in patients with DM2 and nondiabetic patients. Patients and Methods: Prospective follow-up studies involved patients with gingival squamous cell carcinoma in stage T2-3N0M0. Treatment comprised surgical tumor extirpation, block resection of the mandible, functional cervical dissection, and 60 Gy of adjuvant irradiation. The patients were divided into a group of patients with DM2 (DM group) and a nondiabetic, control group. Progression data was recorded after a 2-year period of clinical follow-up. Surgical samples were assessed histopathologically from the aspect of tumor spread. Results: At the end of a 2-year follow-up period, the DM group demonstrated significantly worse clinical results in terms of cervical lymph node metastases (P <.05) and mortality rate (P <.001). Histologically, the degree of tumor invasion was significantly different in the DM group and controls (P <.01). Conclusion: DM2 can be considered a possible prognostic factor in cases of gingival carcinoma, forecasting an unfavorable course. (C) 2007 American Association of Oral and Maxillofacial Surgeons.