This protocol covers gingival cancer arising on the mandibular gingiva in which the tumour has not invaded underlying bone — including cases where the lesion abuts, but has not penetrated, the periosteum of the mandible.

Mandibular gingival cancer without bone invasion is uncommon. The key clinical distinction in this scenario is whether the tumour merely abuts the mandibular periosteum or has breached it. This boundary directly determines the extent of surgical resection required, and the protocol addresses both situations explicitly.

Surgical approach & resection goals

Surgery centres on resection of the gingival mucosa and periosteum. Whether more extensive mandibular resection is warranted depends on the tumour's precise relationship to the periosteum. The protocol specifies the conditions under which broader bone surgery can be omitted, and sets the threshold of histopathologically uninvolved tissue required to achieve a negative margin. The complete criteria, decision steps, and margin standard are in the full protocol.

References

DOI: 10.21053/ceo.2018.01816

Similar to the maxillary gingiva, mandibular gingival cancer without bone invasion is rare, but the tumor is usually removed by gingival mucosal resection.
(A) Mandibulectomy can be waived if the tumor abuts the periosteum of the mandible (weak recommendation, low quality evidence).
(B) Mucosal/periosteal resection can be considered for lesions without bone invasion (weak recommendation, low quality evidence).
Although more than 5 mm of histopathologically uninvolved tissue margin from the resected tumor is usually regarded as a negative margin in oral cancer, most studies of “margin tissue” have included an evaluation of bone tissue.

View source ↗

Treatment of Mandibular Gingival Cancer Without Bone Invasion

Surgical approach & resection goals

References