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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*
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: [email protected]

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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2015 

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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;2940Google 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