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Guney E, Yigitbasi OG. Functional Surgical Approach to the Level I for Staging Early Carcinoma of the Lower Lip. Otolaryngol Head Neck Surg 2016; 131:503-8. [PMID: 15467626 DOI: 10.1016/j.otohns.2004.04.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE: The management of the neck in patients with T1-T2 carcinoma of the lower lip (LLC) remains controversial. Suprahyoid neck dissection seems a reliable diagnostic approach, although it sacrifices the submandibular gland and its vascularity. STUDY DESIGN AND SETTING: This study was a prospective, randomized study. Patients with previously untreated T1 or T2 primary LLC underwent either classical suprahyoid neck dissection (CSHD) or functional suprahyoid neck dissection (FSHD) in continuity with the resection of the cancer of the lip. RESULTS: A total of 48 suprahyoid neck dissections were performed in 36 patients. Among these dissections, 27 were CSHD and 21 were FSHD. The average number of dissected lymph nodes was similar for both classical and functional type operations. The overall follow-up period was 40.5 months. CONCLUSIONS: The end result of this series supports the idea that FSHD is a reliable diagnostic method for the management of level I lymph nodes in LLC. FSHD can avoid undertreatment or overtreatment of the patients with early LLC while preserving the submandibular gland.
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Affiliation(s)
- E Guney
- Department of Otolarygology-Head and Neck Surgery, Erciyes University School of Medicine, Kayseri, Turkey
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2
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Bhandari K, Wang DC, Li SC, Jiang BH, Guo YX, Koirala U, Du XY. Primary cN0 lip squamous cell carcinoma and elective neck dissection: Systematic review and meta-analysis. Head Neck 2014; 37:1392-400. [PMID: 24839013 DOI: 10.1002/hed.23772] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Revised: 03/11/2014] [Accepted: 05/13/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Management of clinically negative lymph nodes (cN0) in primary lip squamous cell carcinoma (SCC) has always been a controversial topic. METHODS A systematic review of English-language electronic databases using Medline, Embase, Cochrane library, Google Scholar, SCI, and specific journals on the subject matter was done. Only the studies mentioning primary nonmetastatic lip SCC with cN0 neck treated by surgery only and having at least 2 years of follow-up data were selected. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting systematic reviews and meta-analysis was followed. RESULTS The pooled estimate of occult metastasis in neck dissected specimen was 0.17 (95% confidence interval [CI], 0.10-0.28) and that of delayed nodal metastasis in patients without neck dissection was 0.08 (95% CI, 0.01-0.18). CONCLUSION The results do not prove sufficient to justify elective treatment of the neck in primary cN0 lip SCC and close observation would be a viable option in such cases. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1392-1400, 2015.
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Affiliation(s)
- Kishor Bhandari
- Department of Oral and Maxillofacial Surgery, 2nd Affiliated Hospital of Jiamusi University, Jiamusi City, Heilongjiang, People's Republic of China
| | - Dian-can Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Haidian District, Beijing, People's Republic of China
| | - Shan-chang Li
- Department of Oral and Maxillofacial Surgery, 2nd Affiliated Hospital of Jiamusi University, Jiamusi City, Heilongjiang, People's Republic of China
| | - Bing-hua Jiang
- Department of Oral and Maxillofacial Surgery, 2nd Affiliated Hospital of Jiamusi University, Jiamusi City, Heilongjiang, People's Republic of China
| | - Yu-xing Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Haidian District, Beijing, People's Republic of China
| | - Ujjwal Koirala
- Department of Oral and Maxillofacial Surgery, 2nd Affiliated Hospital of Jiamusi University, Jiamusi City, Heilongjiang, People's Republic of China
| | - Xiao-yan Du
- Department of Plastic and Reconstructive Surgery, 2nd Affiliated Hospital of Jiamusi University, Jiamusi City, Heilongjiang, People's Republic of China
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3
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Salgarelli AC, Sartorelli F, Cangiano A, Pagani R, Collini M. Surgical Treatment of Lip Cancer: Our Experience With 106 Cases. J Oral Maxillofac Surg 2009; 67:840-5. [DOI: 10.1016/j.joms.2008.09.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Accepted: 09/06/2008] [Indexed: 12/01/2022]
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4
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Vahtsevanos K, Ntomouchtsis A, Andreadis C, Patrikidou A, Karakinaris G, Mangoudi D, Papanastasiou G, Antoniades K. Distant bone metastases from carcinoma of the lip: a report of four cases. Int J Oral Maxillofac Surg 2007; 36:180-5. [PMID: 17223312 DOI: 10.1016/j.ijom.2006.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2006] [Revised: 06/08/2006] [Accepted: 07/11/2006] [Indexed: 11/15/2022]
Abstract
The lip is estimated to be the most frequent location for carcinoma of the oral cavity. It occurs more frequently in men, especially those with a history of exposure to sunlight. Despite the usually effective management, regional and occasionally distant metastases do occur, especially in advanced stages. In this retrospective analysis of patients with labial carcinoma presenting with distant bone metastases in 1995-2003, the extremely limited number of patients did not allow for multivariate data analysis. From a cohort of 415 patients presenting with lip lesions, 186 cases were diagnosed as carcinoma and managed accordingly. Four patients (2.14%) showed distant bone metastases, one with concurrent axillary node metastasis. Patient demographics, tumour characteristics, case management and survival were evaluated. The distant metastasis patients were of clinical stages II-IV; initial management was wide local excision with reconstruction for all cases, with one undergoing concurrent neck dissection and one adjuvant radiotherapy. Time for distant bone metastasis was 9-21 months, subsequent survival 3-14 months and overall survival 13-35 months. Distant metastases from labial carcinoma are rare, not exceeding 2%. Metastasis to bone and axillary lymph nodes is exceptionally rare and can be attributed to either inadequate initial management or aggressive tumour behaviour.
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Affiliation(s)
- K Vahtsevanos
- Department of Maxillofacial Surgical Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece. vahtsevk@otenet,gr
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5
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Hieken TJ. Cancer of the Lip. Surg Oncol 2006. [DOI: 10.1007/0-387-21701-0_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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6
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Ilić MP, Dzolev A, Kiralj A. [Regional metastases of squamous cell carcinoma of the lower lip]. ACTA ACUST UNITED AC 2003; 56:322-5. [PMID: 14587247 DOI: 10.2298/mpns0308322i] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Lower lip squamous cell carcinoma is the most common oral carcinoma. In relation to other oral carcinomas, it has a better clinical course. If regional metastases appear, lower lip carcinoma has a very poor prognosis. METHODS This study included patients treated for lower lip squamous cell carcinoma in the period 1984-2001. We examined neck metastases and time of their appearance after operation of the primary neoplasm. RESULTS Our retrospective study included 305 patients with lower lip carcinoma in a twelve-year period. Out of this number, 293 had no positive neck lymph nodes, and only 12 patients had (4%). More than 75% of metastases appeared in the first year after surgery of the primary neoplasm. Contra-lateral metastases were most common. CONCLUSION Taking into consideration the percentage of metastases, particularly during the first year after surgery, we suggest identification of sentinel lymph nodes and depending on PH finding one should decide about the type of neck operation. Frequent check-ups are necessary, especially during the first year.
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Affiliation(s)
- Miroslav P Ilić
- Klinika za maksilofacijalnu hirurgiju, Institut za hirurgiju, Klinicki centar, Novi Sad
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7
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Abstract
Cutaneous malignancies are the most common causes of cancer in the United States, and the preponderance occur in the head and neck region. From 0.3% to 13.7% of cutaneous squamous cell carcinomas and from 0.0028% to 0.4% of cutaneous basal cell carcinomas metastasize to the cervical nodes. A description of the head and neck cutaneous lymphatic drainage is presented, followed by recommendations regarding neck dissection modifications appropriate to the primary sites and nodal eschalons involved.
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Affiliation(s)
- R O Brown
- Department of Otolaryngology and Communicative Sciences, Medical University of South Carolina, Charleston 29425, USA
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8
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Koç C, Akyol MU, Celikkanat S, Cekiç A, Ozdem C. Role of suprahyoid neck dissection in the treatment of squamous cell carcinoma of the lower lip. Ann Otol Rhinol Laryngol 1997; 106:787-9. [PMID: 9302914 DOI: 10.1177/000348949710600915] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Treatment of squamous cell carcinoma of the lip is primarily surgical. Unlike other oral lesions, lower lip cancers do not metastasize to lower cervical lymph nodes without invading submental and submandibular lymph nodes. This study presents 30 patients with N0 lower lip carcinoma who were treated by en bloc resection of the tumor with suprahyoid neck dissection. Occult metastasis was found in 4 patients (13%). Four patients, 3 of whom had no occult metastases, died of local or regional uncontrollable disease. Suprahyoid or modified radical neck dissection appears to be beneficial, even in small tumors of the lower lip, in detecting occult metastases.
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Affiliation(s)
- C Koç
- 2nd Otolaryngology Clinic, Ankara Numune Hospital, Turkey
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9
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Luce EA, Goldberg DP. Oncologic and Reconstructive Considerations in Nonmelanotic Skin and Lip Cancers. Surg Oncol Clin N Am 1996. [DOI: 10.1016/s1055-3207(18)30352-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Abstract
Cigarette smoking is strongly linked to serious internal diseases such as cancer, cardiovascular disease, and lung disease. However, the external manifestations and consequences of smoking are relatively unknown. Although generally less ominous, the cutaneous manifestations of smoking may be associated with significant morbidity. This article reviews the known adverse effects on the skin of smoking.
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Affiliation(s)
- J B Smith
- Department of Internal Medicine, University of South Florida College of Medicine, Tampa 33602, USA
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de Visscher JG, Grond AJ, Botke G, van der Waal I. Results of radiotherapy for squamous cell carcinoma of the vermilion border of the lower lip. A retrospective analysis of 108 patients. Radiother Oncol 1996; 39:9-14. [PMID: 8735488 DOI: 10.1016/0167-8140(96)01716-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The authors analyzed the clinical history, tumor histology and stage, and outcome of a group of 108 patients with squamous cell carcinoma (SCC) of the vermilion border of the lower lip who underwent radiation therapy in the period between 1980 and 1992. The median follow-up was 77 months. The disease stages were T1 in 89 (82.4%), T2 in 17 (15.7%), and T3 in 2 cases (1.9%). At presentation, regional lymph nodes were clinically negative in all but 3 patients. The total tumor dose varied from 48 Gy to 70 Gy, depending on the radiation modality (orthovoltage, electrons, photontherapy and iridium implants). Local control was achieved in 88 out of 89 (98.9%) patients with T1, in 13 out of 17 (76.5%) patients with T2 and in both patients with T3 tumors. Local treatment failures (4.6%) were cured by salvage surgery. During follow-up, regional lymph node metastases at level I (submental and submandibular groups) occurred in 11 out of 89 (12.4%) patients with stage I and in I out of 15 (6.7%) patients with stage II tumors. All these patients underwent therapeutic neck dissection, followed by radiotherapy in 8 cases. Two patients developed distant metastases. Thus, after salvage treatment of local failures and regional metastases the total group of patients with stage I and II SCCs of the vermilion border of the lower lip showed a definitive control rate of 98.1%.
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Affiliation(s)
- J G de Visscher
- Department of Oral and Maxillofacial Surgery, Medisch Centrum Leeuwarden, The Netherlands
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dos Santos LR, Cernea CR, Kowalski LP, Carneiro PC, Soto MN, Nishio S, Hojaij FC, Dutra Júnior A, Britto e Silva Filho G, Ferraz AR. Squamous-cell carcinoma of the lower lip: a retrospective study of 58 patients. SAO PAULO MED J 1996; 114:1117-26. [PMID: 9077021 DOI: 10.1590/s1516-31801996000200003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The charts of 58 patients with squamous-cell carcinomas of the lower lip, treated at the General Hospital of the University of São Paulo Medical School from January 1980 to December 1989, were retrospectively analyzed. In addition to regular demographic data, all available information was collected regarding: smoking and drinking habits; sun exposure; clinical stage; macroscopic features of the primary lesions; type of treatment; and follow-up. A meticulous pathological analysis, comprising the histologic differentiation grade, maximal tumor thickness, sun elastosis, perineural spread, vascular and muscular invasion, surgical margins, peritumoral inflammatory infiltrate, and positive lymph nodes, with or without extracapsular spread, was undertaken as well. The evaluation of the overall 5-year survival showed significant statistical differences, with prognostic implications, for the following variables: maximal tumor thickness, T-stage and positive nodes.
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Affiliation(s)
- L R dos Santos
- Department of Head and Neck Surgery, General Hospital of the University of São Paulo Medical School, Brazil
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14
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Califano L, Zupi A, Massari PS, Giardino C. Lymph-node metastasis in squamous cell carcinoma of the lip. A retrospective analysis of 105 cases. Int J Oral Maxillofac Surg 1994; 23:351-5. [PMID: 7699273 DOI: 10.1016/s0901-5027(05)80053-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
During 1975-87, 105 patients with squamous cell carcinoma (SCC) of the lip were surgically treated. All patients underwent radical resection of the tumor. Only the patients with palpable lymph nodes had a simultaneous neck dissection. All patients were followed up for at least 5 years. Of the 80 patients without palpable lymph nodes, only three developed lymph-node metastasis. Of the 25 patients with palpable lymph nodes who underwent modified neck dissection, four had recurrence of lymph-node metastasis at a different level. The over-all 5-year survival rate was 97%. The survival rate for patients with lymph-node metastasis was 88%.
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Affiliation(s)
- L Califano
- Department of Maxillo-Facial Surgery, School of Medicine and Surgery, Federico II University of Naples, Italy
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16
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Abstract
PURPOSE Most patients with squamous cell carcinoma of the lower lip present with early disease and follow a rather indolent clinical course. Determinant 5-year survival rates range from 85% to 95%. This study was undertaken in an attempt to gain insight into the cause of failure in those few patients who develop recurrent disease. PATIENTS AND METHODS A retrospective review was completed on patients treated between 1964 and 1990. Patients were staged according to the American Joint Committee. Patients with no palpable adenopathy had either a unilateral or bilateral suprahyoid dissection performed. Patients with palpable adenopathy underwent radical neck dissection. All patients were followed for evidence of recurrent disease. RESULTS The records of 92 patients treated surgically for squamous cell carcinoma of the lower lip were available and complete. Palpable adenopathy was present in 38 patients; however, only 8 of these patients (21%) were histologically positive. Of the 54 patients judged to be free of disease, 3 (5.5%) had histologic evidence of metastasis. Overall, the incidence of cervical metastasis was 12%. CONCLUSION The incidence of cervical metastasis in patients with squamous cell carcinoma of the lip is low; however, these data suggest that the size of the primary tumor does not correlate closely with predicting the incidence of regional lymph node metastases.
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Affiliation(s)
- I N Hosal
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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18
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Teichgraeber JF, Larson DL. Some oncologic considerations in the treatment of lip cancer. Otolaryngol Head Neck Surg 1988; 98:589-92. [PMID: 3138617 DOI: 10.1177/019459988809800609] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We evaluated the treatment and results of 46 patients with lip cancer of commissure origin or extension. The patients were evaluated by clinical stage and pathologic findings. Treatment was predominantly by surgery for T1 and T2 lesions (31 of 37 patients), whereas combined resection and radiation therapy was used for larger tumors. The results showed control of both very large and very small lesions, but T2 lesions had repeated recurrences. We therefore recommended aggressive therapy for T2 and higher classifications of lip cancer with commissure involvement.
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Affiliation(s)
- J F Teichgraeber
- Department of Surgery, University of Texas Health Science Center, Houston
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19
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Abstract
The history of surgical reconstruction of the lips is outlined and a series of procedures described, which together enable lip reconstruction to be successfully undertaken in a variety of different circumstances.
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Affiliation(s)
- J D Langdon
- Department of Oral and Maxillofacial Surgery, King's College School, Medicine and Dentistry, London, Great Britain
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20
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21
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Abstract
Carcinoma of the lower lip is sufficiently common in occurrence that a practitioner should be cognizant of the requisite diagnostic and therapeutic guidelines. This article discusses the pertinent anatomy, the management of the local or primary lesion, and some prognostic criteria for surgical decisions directed toward the regional lymph nodes. Reconstruction is discussed from the standpoint of magnitude of the defect as a percentage of the total lip transverse diameter.
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Pitkänen J, Lahti A, Sundell B. Carcinoma of the lip. A retrospective study of 70 patients. SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY 1985; 19:289-94. [PMID: 4095514 DOI: 10.3109/02844318509074517] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
From 1966 to 1978, 70 patients with carcinoma of the lip were treated at the Division of Plastic Surgery, University Central Hospital, Helsinki. The lip tumour was a squamous cell carcinoma in 64 patients, and a basal cell carcinoma in 6 patients. Of these 70 patients, 24 had radiotherapy as the primary mode of therapy and 46 patients had been treated initially by surgery. The results of surgery were generally good. However, in the group of "simple wedge excision" and in patients who had had radiotherapy as the primary treatment there was a higher incidence of recurrences. In the former group the recurrences were considered to be due to a too narrow angle of excision. We recommend surgery as the primary method of treatment because of the availability of histologically accurate tumour margin assessment, the short rehabilitation period and the good functional results achieved.
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Douglass CW, Gammon MD. Reassessing the epidemiology of lip cancer. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1984; 57:631-42. [PMID: 6377170 DOI: 10.1016/0030-4220(84)90286-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The risk factors associated with carcinoma of the lip are reviewed with an aim toward reassessing the epidemiology of the disease. Descriptive studies show lip cancer to occur most commonly in aging white men. The geographic distribution of the disease varies widely, both nationally and internationally; recent studies show that at the national level there is not a uniformly high risk of lip cancer across the sunny states, as has been believed. Secular disease trends show a decline in both morbidity and mortality while survival rates have remained stable. The risk factors consistently associated with lip cancer are rural residence and outdoor occupation, but the latter does not apply to all outdoor workers. In addition, both actinic radiation and tobacco smoking have long been considered to be causally related to lip cancer. An extensive review of the literature, however, reveals that the studies evaluating the association between these exposure variables and the disease do not yield consistent results; in addition, many recent, well-designed studies fail to support independent causal hypotheses. We conclude that (1) any risk factors considered to be causally related to lip cancer must be congruent with the descriptive factors (geographic distribution, secular disease trends, etc.) and (2) although sunlight and smoking are highly likely risk factors, their interrelationship as well as their interaction with other factors, such as genetic predisposition, needs reassessment.
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Knabel MR, Koranda FC, Panje WR, Grande DJ. Squamous-cell carcinoma of the upper lip. THE JOURNAL OF DERMATOLOGIC SURGERY AND ONCOLOGY 1982; 8:487-91. [PMID: 7096774 DOI: 10.1111/j.1524-4725.1982.tb01118.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Squamous-cell carcinoma involving the upper lip grows more rapidly and is more difficult to control than squamous-cell carcinoma of the lower lip. The lesion usually is histologically more undifferentiated than squamous-cell carcinoma of the lower lip and metastases develop earlier. A case report of a patient with a squamous-cell carcinoma in an upper lip with regional metastases is presented and illustrated.
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Abstract
Certain risk factors appear to separate subjects with repeated primary carcinomas of the lip from the general population of patients with carcinoma of the lip. Factors that were found statistically significant in increasing the chance of recurrent carcinoma of the lip include outdoor occupations requiring prolonged exposure to sunlight or the use of tobacco on a regular basis. Significant risk factors of a clinical nature include a positive serologic reaction for syphilis; the presence of leukoplakia, hyperkeratosis, or actinic cheilitis; or the presence of a basal cell or squamous cell carcinoma of the facial skin.
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Abstract
Carcinoma of the lip is a common variety of head and neck malignancy frequently seen in the elderly Caucasian male. Three hundred and fifty consecutive cases of invasive squamous cell carcinoma of the lip are anlayzed and the treatment methods and their results are presented. Surgical management is recommended for most patients because of the advantage of tumor margin assessment, avoidance of radiotherapy complications, and rapid rehabilitation.
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Loré JM, Kaufman S, Grabau JC, Popović DN. Surgical Management and Epidemiology of Lip Cancer. Otolaryngol Clin North Am 1979. [DOI: 10.1016/s0030-6665(20)32496-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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