When gingival cancer of the maxillary gingiva extends into the underlying bone, it represents an advanced local stage that requires a distinct surgical approach. This protocol outlines the structured management for this specific scenario.
In maxillary gingival cancer, superficial erosion of the bone or tooth socket alone is not sufficient to define this presentation. Full invasion of the underlying bone is required, and when present, it significantly changes the operative plan. Because of this bone involvement, the majority of surgical procedures for gingival cancer in this setting require resection of bony structures.
Management involves partial resection of the maxillary bone. The specific type of resection and its extent are determined by the size and growth characteristics of the tumor. Multiple resection approaches exist; the full structured algorithm — including how to select among them — is available via the link below.
The primary pathological target is achieving a clear resection margin. A clear surgical margin of at least 5 mm on final pathology is the documented benchmark for adequacy.
DOI: 10.21053/ceo.2018.01816