Surgical management of squamous cell carcinoma of the lip: analysis of a 10-year experience in 223 patients.

ABSTRACT

BACKGROUND: The most common type of lip carcinoma is squamous cell carcinoma (SCC), accounting for approximately 90% of all oral malignancies. Currently, surgery and/or radiotherapy are considered the standards of care for SCC of the lip. MATERIALS AND METHODS: We retrospectively analyzed medical records of patients diagnosed with SCC of the lip at the Clinic for Maxillofacial surgery at University of Belgrade (Belgrade, Serbia) during a period between 1991 and 2000. RESULTS: A total of 223 patients with SCC of the lip were diagnosed and treated during a 10-year period. The overall male-to-female ratio was 5 to 0. The most frequently affected site was the lower lip (92.8%). Mean diameter of the tumor was 30.1 mm (range, 5 to 80 mm). Neck lymph node metastases at presentation was detected in 26.5% of patients, who subsequently underwent neck dissection. We observed a linear trend in the association between the size of the tumor and the clinical stage of the neck (chi2 = 15.1; df = 1; P < .0001). Different surgical techniques were used for reconstruction of the lip defect after tumor removal. After a median follow-up of 56 months (range, 15 to 78 months), local recurrence occurred in 10.8% of patients while regional metastases developed in 4.5% of patients. Mortality from SCC of the lip was only 2.2%. CONCLUSION: SCC of the lip generally has a favorable outcome. Recently, there have been no major advances in lip reconstruction but rather continued improvement on accepted techniques. Early detection is essential for the successful treatment of SCC of the lip, which requires a multidisciplinary approach.