Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-27T22:15:08.544Z Has data issue: false hasContentIssue false
  • English
  • Français

Squamous cell carcinoma of the lip: depth of invasion, local recurrence and regional metastases. Experience of a rural multidisciplinary head and neck unit

Published online by Cambridge University Press:  25 August 2015

A Pastuszek ,
M Hanson  and
R Grigg
A Pastuszek*
Affiliation:
Ear, Nose and Throat Surgical Department, Toowoomba General Hospital, Queensland, Australia
M Hanson
Affiliation:
Ear, Nose and Throat Surgical Department, Toowoomba General Hospital, Queensland, Australia
R Grigg
Affiliation:
Ear, Nose and Throat Surgical Department, Toowoomba General Hospital, Queensland, Australia
*
Address for correspondence: Dr Andrew Pastuszek, 8 Long Island Court, Mermaid Waters, QLD 4218, Australia Fax: +61 (0)746 165 122 E-mail: atpastuszek@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The internationally recognised American Joint Committee on Cancer (tumour–node–metastasis) staging system utilises tumour size to determine stage. Other factors (i.e. tumour depth) may provide additional prognostic information.

Method:

A thorough retrospective analysis was performed of 68 patients with primary lip squamous cell carcinoma operated on or discussed by the Darling Downs Health Service between 2005 and 2013.

Results:

Twelve patients developed lymphatic spread. There was a statistically significant increased risk of nodal metastasis in: patients with tumours of increased thickness (U = 103.50; degrees of freedom = 68; p < 0.001), those with a larger overall tumour size (U = 163.50; degrees of freedom = 68; p = 0.005) and patients living further from the treatment centre (U = 199.00; degrees of freedom = 68; p = 0.018).

Conclusion:

It may be reasonable that other factors are considered for staging of lip squamous cell carcinomas, in combination with tumour–node–metastasis staging. Depth of invasion may have utility in prognosis and treatment; however, larger prospective analysis needs to be performed. Patients living in a more rural setting presented with more advanced disease, suggesting an ongoing rural–metropolitan gap in healthcare.

Keywords

LipCarcinoma, EpidermoidCarcinoma, PlanocellularCarcinoma, SquamousSquamous Cell CarcinomaPrognosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue S1 , January 2016 , pp. S32 - S37
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Australian Society of Otolaryngology Head and Neck Surgery 64th Annual Scientific Meeting, 1 April 2014, Brisbane, Queensland, Australia.

References

1Ariyawardana, A, Johnson, NW.Trends of lip, oral cavity and oropharyngeal cancers in Australia 1982–2008: overall good news but with rising rates in the oropharynx. BMC Cancer 2013;13:333CrossRefGoogle ScholarPubMed
2Onerci, M, Yilmaz, T, Gedikoglu, G.Tumour thickness as a predictor of cervical lymph node metastasis in squamous cell carcinoma of the lower lip. Otolaryngol Head Neck Surg 2000;122:139–42Google Scholar
3Zitsch, RP 3rd, Park, CW, Renner, GJ, Rea, JL.Outcome analysis for lip carcinoma. Otolaryngol Head Neck Surg 1995;113:589–96CrossRefGoogle ScholarPubMed
4American Joint Committee on Cancer. Lip and oral cavity. In: Edge, SB, Byrd, DR, Compton, CC et al. , eds. AJCC Cancer Staging Manual, 7th edn.New York: Springer, 2010;29–40Google ScholarPubMed
5Frierson, HF Jr, Cooper, PH.Prognostic factors in squamous cell carcinoma of the lower lip. Hum Pathol 1986;17:346–54Google Scholar
6Onerci, TM. Indications for neck dissection in lower lip carcinoma. In: American Society of Head & Neck Surgery, Pittsburgh. Proceedings of the 4th International Conference on Head and Neck Cancer. Toronto: American Journal of Otolaryngology, 1996;472–7Google Scholar
7Najim, M, Cross, S, Gebski, V, Palme, CE, Morgan, GJ, Veness, MJ.Early-stage squamous cell carcinoma of the lip: the Australian experience and the benefits of radiotherapy in improving outcome in high-risk patients after resection. Head Neck 2013;35:1426–30Google Scholar
8Vanderlei, JP, Pereira-Filho, FJ, da Cruz, FA, de Mello, FL, Kruschewsky Lde, S, de Freitas, LC et al. Management of neck metastases in T2N0 lip squamous cell carcinoma. Am J Otolaryngol 2013;34:103–6Google Scholar
9Yilmaz, S, Ercocen, AR.Is elective neck dissection in T1-2, N0 patients with lower lip cancer necessary? Ann Plast Surg 2009;62:381–3CrossRefGoogle ScholarPubMed
10Hosal, IN, Onerci, M, Kaya, S, Turan, E.Squamous cell carcinoma of the lower lip. Am J Otolaryngol 1992;13:363–5CrossRefGoogle ScholarPubMed