1
|
Lian H, Hua Y, Paka Lubamba G, Zhang G, Bao M, Wang G, Zhao G, Gao N, Yan B, Li C. Reconstruction of extensive lower lip defects using vascularized mucosal flap with external skin complex tissue. Oral Oncol 2024; 159:107056. [PMID: 39342787 DOI: 10.1016/j.oraloncology.2024.107056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2024] [Accepted: 09/23/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND The complexity of lip anatomy and the roles played by the lip make the reconstruction of lip defects more challenging. Adequate reconstruction of lip defects requires adaptation of mucosa, vermilion, and skin features in lip as well as its specific function. METHODS A 59-year-old male with left lower lip cancer underwent en-bloc resection and left selective neck dissection (SND), followed by immediate reconstruction using Facial Artery Myomucosal Island Flap (FAMMIF) with external Skin Complex Tissue. RESULTS The use of chimeric flap based on FAMMIF and its external skin tissue allowed minimizing the postoperative problem of combination of both aesthetic and functional impairments. The FAMMIF is suitable for the reconstruction of lip mucosa and lip vermilion, while the external skin tissue can be use to replace the external lip skin defect. The patient was satisfied with the treatment outcomes. He is undergoing follow-up without any evidence of recurrence. CONCLUSION FAMMIF with external skin complex tissue, as a reconstructive approach selected in our case of lip defect secondary to lip cancer resection, combined the reconstruction of both aesthetics and functions of the lower lip. The technique was found feasible and provided satisfactory postoperative outcomes.
Collapse
Affiliation(s)
- Haosen Lian
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yufei Hua
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Grace Paka Lubamba
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Oral and Maxillofacial Surgery, University Clinics of Kinshasa, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, Congo
| | - Gaowei Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Mingzhe Bao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Guanru Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Guile Zhao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ning Gao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bing Yan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Chunjie Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| |
Collapse
|
2
|
Mercke C, Friesland S, Berglund A, Johansson GW, Margolin G, Gubanski M, Björgvinsson E, Nilsson J. "High-risk" tumors of the lip treated with external beam radiotherapy and high-dose-rate brachytherapy: Long-term outcome. Head Neck 2024. [PMID: 39327222 DOI: 10.1002/hed.27936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 08/28/2024] [Accepted: 09/04/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Radiotherapy is a well-established treatment for lip cancer, with external radiotherapy (EBRT) or brachytherapy (BT). METHODS This study evaluated outcome, tumor control, and aesthetics, for 101 patients with carcinoma of the lip, not suitable for surgery, treated with combined EBRT and BT. RESULTS Squamous cell carcinoma was seen in 78 patients, basal cell carcinoma in 15, and other histologies in 8 patients. Tumors were advanced: 73% in category T2-T4. Local control at 3 and 5 years was 89%. Local failure appeared in 4/56 patients (7%) with primary RT compared to 7/45 (16%) in those with prior surgery, regional recurrence in 5 patients. Toxicity was mild. Cosmetic outcome, 87 patients evaluated, was bad for 9/40 patients with upfront surgery compared to 1/47 for primary RT patients (p = 0.003). Seven patients died from lip cancer (7%), three with originally N+ disease (43%). CONCLUSIONS Combined EBRT and BT could be considered for lip tumors not candidates for surgery.
Collapse
Affiliation(s)
- Claes Mercke
- Department of Head, Neck, Lung and Skin Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Signe Friesland
- Department of Head, Neck, Lung and Skin Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Anders Berglund
- Epistat Epidemiology and Statistics Consulting, Uppsala, Sweden
| | - Gun Wickart Johansson
- Department of Head, Neck, Lung and Skin Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Gregori Margolin
- Department of Head, Neck, Lung and Skin Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Michael Gubanski
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Radiation Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Einar Björgvinsson
- Department of Head, Neck, Lung and Skin Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Josef Nilsson
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
3
|
Akdemir O, Eyuboglu AA, Lineaweaver W, Zhang F. Clinical outcomes of bilobed platysma myocutaneous flap technique with neck dissection in lower lip squamous cell carcinoma. Surg Oncol 2024; 57:102130. [PMID: 39265261 DOI: 10.1016/j.suronc.2024.102130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 09/01/2024] [Accepted: 09/05/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Squamous cell carcinoma (SCC) in the lower lip is among the most frequently encountered types of cancer. As the size of this cancer increases, the need for reconstruction becomes evident, posing a significant challenge. Depending on the staging results in these patients, neck dissection may be recommended. OBJECTIVE This study aims to demonstrate the successful application or feasibility of our Bilobed Platysma Myocutaneous Flap technique in patients with lower lip SCC. METHODS The Bilobed Platysma Myocutaneous Flap was applied to all patients. Following TNM staging, supraomohyoid and/or radical neck dissection were performed. Surveys were conducted with the patients, and scoring was implemented based on the results for evaluation. RESULTS Between 2014 and 2018, 23 patients underwent treatment with this flap, and all flaps survived. Among these patients, bilateral supraomohyoid neck dissection was performed on 14, while modified radical neck dissection on one side and supraomohyoid neck dissection on the other side were conducted on the remaining 9 patients. Throughout the 5-year follow-up period, no recurrence was observed in the patients. CONCLUSION The combination of the Bilobed Platysma Myocutaneous Flap technique and neck dissection can be successfully employed in the reconstruction and treatment of lower lip cancers.
Collapse
Affiliation(s)
- Ovunc Akdemir
- Istanbul Aydın University, Department of Plastic, Aesthetic and Reconstructive Surgery, Istanbul, Turkey.
| | - Atilla Adnan Eyuboglu
- Arel University, Department of Plastic, Aesthetic and Reconstructive Surgery, Istanbul, Turkey
| | - William Lineaweaver
- Vanderbilt University Medical Center, Department of Plastic Surgery, Nashville, TN, USA
| | - Feng Zhang
- Fudan University, Department of Plastic Surgery, Zhongshan Hospital, Shanghai, China
| |
Collapse
|
4
|
Ettl T, Gottsauner M, Kühnel T, Maurer M, Schuderer JG, Spörl S, Taxis J, Reichert TE, Fiedler M, Meier JK. The Folded Radial Forearm Flap in Lip and Nose Reconstruction-Still a Unique Choice. J Clin Med 2023; 12:jcm12113636. [PMID: 37297831 DOI: 10.3390/jcm12113636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/16/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023] Open
Abstract
(1) Background: The radial forearm flap (RFF) has evolved as the flap of choice for intraoral mucosal reconstructions, providing thin and pliable skin with a safe blood supply. Perforator flaps such as the anterolateral thigh (ALT) flap are increasingly being discussed for the same applications. (2) Methods: Patient history, treatment details, and outcome of 12 patents with moderate to extended defects of the lip and/or nose area that were reconstructed by a folded radial forearm flap were retrospectively evaluated for oncologic and functional outcomes. (3) Results: The mean oncologic and functional follow-up were 21.1 (min. 3.8; max. 83.3) and 31.2 (min. 6; max. 96) months, respectively. All flaps survived without revision. In eight cases, major lip defects were reconstructed by an RFF; in six patients, the palmaris longus tendon was included for lip suspension. The functional results in terms of eating, drinking, and mouth opening were good in five cases, while three patients were graded as fair due to moderate drooling. In seven cases, the major parts of the nose were reconstructed with two good and five fair (nostril constriction in three cases) functional results. (4) Conclusions: The folded RFF remains a unique free flap option for complex three-dimensional lip and nose reconstructions in terms of flexibility, versatility, and robustness.
Collapse
Affiliation(s)
- Tobias Ettl
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Maximilian Gottsauner
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Thomas Kühnel
- Department of Otorhinolaryngology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Michael Maurer
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Johannes G Schuderer
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Steffen Spörl
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Jürgen Taxis
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Torsten E Reichert
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Mathias Fiedler
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Johannes K Meier
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| |
Collapse
|
5
|
Wang J, Murase M, Towithelertkul C, Tani H, Sumita YI. Custom-made radiotherapy prosthesis for external and internal radiotherapy in a patient with lip cancer. J Oral Sci 2023; 65:65-68. [PMID: 36529514 DOI: 10.2334/josnusd.22-0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Definitive radiotherapy is an effective treatment for early-stage lip cancer. The goal of radiotherapy is to irradiate the cancer site effectively while protecting healthy surrounding tissue from the adverse effects of radiation. To this end, radiotherapy prostheses have been widely and effectively used. A maxillofacial prosthodontist working in collaboration with a radiation oncologist can create a custom-made radiotherapy prosthesis that minimizes adverse effects. This report demonstrates the successful use of spacers in external beam radiotherapy and brachytherapy in consideration of the patient's radiation therapy treatment plan and wearing conditions, ensuring adequate availability and preventing radiation-related complications.
Collapse
Affiliation(s)
- Jiangyu Wang
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Mai Murase
- Clinic for Maxillofacial Prosthetics, Tokyo Medical and Dental University Hospital
| | - Cheewin Towithelertkul
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.,Maxillofacial Prosthetics Services, Faculty of Dentistry, Mahidol University
| | - Hiroko Tani
- Clinic for Maxillofacial Prosthetics, Tokyo Medical and Dental University Hospital
| | - Yuka I Sumita
- Clinic for Maxillofacial Prosthetics, Tokyo Medical and Dental University Hospital
| |
Collapse
|
6
|
Copelli C, Manfuso A, Cassano L, Pederneschi N, Tewfik K, Pansini A, Cocchi R. Recurrent squamous cell carcinoma of the lower lip: salvage surgery outcome. Br J Oral Maxillofac Surg 2021; 59:921-927. [PMID: 34456078 DOI: 10.1016/j.bjoms.2020.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 10/18/2020] [Indexed: 11/16/2022]
Abstract
Squamous cell carcinoma (SCC) of the lip is one of the most commonly occurring oral cancers, mainly involving the lower lip. Despite a good prognosis in cases of early detection, survival rates drop dramatically in the presence of recurrence. While there are many studies in the literature regarding the management of primary tumours, the rate of recurrence in lower lip SCC is low and therefore there are few data and articles about them. We retrospectively reviewed patients affected by recurrent SCC of the lower lip treated surgically from 2011 to 2019 in a single centre. Data and results were compared with those in the literature. A total of 16 patients (mean [range] age: 78.1 [62-93] years) were eligible for inclusion. The disease-free survival rate at 2 and 5 years was 29.6% and the overall survival rate at 2 and 5 years was 14.4%. A significantly higher rate of failure and a worse prognosis was observed in patients with neck involvement. The prognosis of recurrent lower lip SCC is unfavourable with extremely low survival rates. This issue is probably linked to the oncological pathology but also to the advanced age of most patients, the presence of several comorbidities and, consequently, the high risk of perioperative mortality. For this reason, the analysis of data sets reported in the literature may help the surgeon in the management of recurrences and selection of patients.
Collapse
Affiliation(s)
- C Copelli
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Foundation IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy.
| | - A Manfuso
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Foundation IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy
| | - L Cassano
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Foundation IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy
| | - N Pederneschi
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Foundation IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy
| | - K Tewfik
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Foundation IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy
| | - A Pansini
- Operative Unit of Maxillo-Facial Surgery, Federico II University, Naples, Italy
| | - R Cocchi
- Operative Unit of Maxillo-Facial Surgery, Otolaryngology and Dentistry, Foundation IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy
| |
Collapse
|
7
|
Cho SI, Sun S, Mun JH, Kim C, Kim SY, Cho S, Youn SW, Kim HC, Chung JH. Dermatologist-level classification of malignant lip diseases using a deep convolutional neural network. Br J Dermatol 2019; 182:1388-1394. [PMID: 31449661 DOI: 10.1111/bjd.18459] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Deep convolutional neural networks (DCNNs) can classify skin diseases at a level equivalent to a dermatologist, but their performance in specific areas requires further research. OBJECTIVE To evaluate the performance of a trained DCNN-based algorithm in classifying benign and malignant lip diseases. METHODS A training set of 1629 images (743 malignant, 886 benign) was used with Inception-Resnet-V2. Performance was evaluated using another set of 344 images and 281 images from other hospitals. Classifications by 44 participants (six board-certified dermatologists, 12 dermatology residents, nine medical doctors not specialized in dermatology and 17 medical students) were used for comparison. RESULTS The outcomes based on the area under curve, sensitivity and specificity were 0·827 [95% confidence interval (CI) 0·782-0·873], 0·755 (95% CI 0·673-0·827) and 0·803 (95% CI 0·752-0·855), respectively, for the set of 344 images; and 0·774 (95% CI 0·699-0·849), 0·702 (95% CI 0·579-0·808) and 0·759 (95% CI 0·701-0·813), respectively, for the set of 281 images. The DCNN was equivalent to the dermatologists and superior to the nondermatologists in classifying malignancy. After referencing the DCNN result, the mean ± SD Youden index increased significantly for nondermatologists, from 0·201 ± 0·156 to 0·322 ± 0·141 (P < 0·001). CONCLUSIONS DCNNs can classify lip diseases at a level similar to dermatologists. This will help unskilled physicians discriminate between benign and malignant lip diseases. What's already known about this topic? Deep convolutional neural networks (DCNNs) can classify malignant and benign skin diseases at a level equivalent to dermatologists. The lips are a unique feature in terms of histology and morphology. Previous studies of DCNNs have not investigated tumours on specific locations. What does this study add? This study shows that DCNNs can distinguish rare malignant and benign lip disorders at the same rate as dermatologists. DCNNs can help nondermatologists to distinguish malignant lip diseases. What are the clinical implications of this work? DCNNs can distinguish malignant and benign skin diseases even at specific locations such as the lips, as well as board-certified dermatologists. Malignant lip diseases are rare and difficult for less trained doctors to differentiate them from benign lesions. This study shows that in dermatology, DCNN can help improve decision-making processes for rare skin diseases in specific areas of the body.
Collapse
Affiliation(s)
- S I Cho
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - S Sun
- Interdisciplinary Program, Bioengineering Major, Graduate School, Seoul National University, Seoul, Korea
| | - J-H Mun
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| | - C Kim
- Seoul National University College of Medicine, Seoul, Korea
| | - S Y Kim
- Seoul National University College of Medicine, Seoul, Korea
| | - S Cho
- Department of Dermatology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - S W Youn
- Department of Dermatology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - H C Kim
- Interdisciplinary Program, Bioengineering Major, Graduate School, Seoul National University, Seoul, Korea.,Department of Biomedical Engineering, and Medical Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - J H Chung
- Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
8
|
Ant A, Kilic C, Baltu Y, Duran AB, Tunccan T, Ozlugedik S, Bozdogan N. Lip cancer: Reconsidering the at‐risk patients with pathological assessment. Oral Dis 2019; 25:742-749. [DOI: 10.1111/odi.13017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/16/2018] [Accepted: 12/05/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Ayca Ant
- Department of Otorhinolaryngology, Head and Neck Surgery Ankara A.Y. Oncology Education and Research Hospital Ankara Turkey
| | - Caner Kilic
- Department of Otorhinolaryngology, Head and Neck Surgery Ankara A.Y. Oncology Education and Research Hospital Ankara Turkey
| | - Yahya Baltu
- Department of Plastic and Reconstructive Surgery Ankara A.Y. Oncology Education and Research Hospital Ankara Turkey
| | - Arzu Betul Duran
- Department of Otorhinolaryngology, Head and Neck Surgery Ankara A.Y. Oncology Education and Research Hospital Ankara Turkey
| | - Tuncay Tunccan
- Department of Otorhinolaryngology, Head and Neck Surgery Ankara A.Y. Oncology Education and Research Hospital Ankara Turkey
| | - Samet Ozlugedik
- Department of Otorhinolaryngology, Head and Neck Surgery Ankara A.Y. Oncology Education and Research Hospital Ankara Turkey
| | - Nazan Bozdogan
- Department of Pathology Ankara A.Y. Oncology Education and Research Hospital Ankara Turkey
| |
Collapse
|
9
|
Majumdar B, Patil S, Sarode SC, Sarode GS, Rao RS. Clinico-pathological prognosticators in oral squamous cell carcinoma. TRANSLATIONAL RESEARCH IN ORAL ONCOLOGY 2017. [DOI: 10.1177/2057178x17738912] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Barnali Majumdar
- Department of Oral Pathology and Microbiology, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Sachin C Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
| | - Gargi S Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
| | - Roopa S Rao
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| |
Collapse
|
10
|
Strieder L, Coutinho-Camillo CM, Costa V, da Cruz Perez DE, Kowalski LP, Kaminagakura E. Comparative analysis of three histologic grading methods for squamous cell carcinoma of the lip. Oral Dis 2016; 23:120-125. [PMID: 27667675 DOI: 10.1111/odi.12586] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/30/2016] [Accepted: 09/11/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate three histologic grading methods for squamous cell carcinoma (SCC) of the lip, the conventional three-grade model proposed by the World Health Organization, tumor budding and depth of invasion (BD) model, and histologic risk assessment (HRA) model, and to correlate them with prognosis. MATERIALS AND METHODS Fifty-three patients with lip SCC were evaluated. RESULTS The mean age was 65 years, 69.8% of the participants were men, and 66.0% of the patients had early-stage tumors. Using the BD and conventional three-grade methods, 52.8% and 64.2% of the cases were graded as low risk, respectively. The HRA model graded 54.7% of the cases as medium risk. In the BD model, the higher histologic grade was associated with worse prognosis (P = 0.045). Overall survival at 5 years was 87.8%. Tumor size (T3 + T4) and lymph node involvement (N+) were associated with reduced overall survival and recurrence-free survival (RFS) (P = 0.002 and 0.005; 0.007 and 0.01, respectively). Surgical treatment combined with radiotherapy was associated with lower RFS (P = 0.03). CONCLUSIONS High-grade lip SCC in advanced stages is associated with a poor prognosis. The BD model is a simple and effective tool for the prognostic evaluation of lip SCC.
Collapse
Affiliation(s)
- L Strieder
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP - Univ. Estadual Paulista, São José dos Campos, Brazil
| | | | - V Costa
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP - Univ. Estadual Paulista, São José dos Campos, Brazil
| | - D E da Cruz Perez
- Department of Clinical and Preventive Dentistry, Federal University of Pernambuco, Recife, Brazil
| | - L P Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - E Kaminagakura
- Department of Bioscience and Oral Diagnosis, Institute of Science and Technology, UNESP - Univ. Estadual Paulista, São José dos Campos, Brazil
| |
Collapse
|
11
|
Kuscu O, Bajin MD, Süslü N, Hoşal AŞ. The role of suprahyoid neck dissection in the treatment of squamous cell carcinoma of the lower lip: 20 years' experience at a Tertiary Center. J Craniomaxillofac Surg 2016; 44:1404-7. [PMID: 27427340 DOI: 10.1016/j.jcms.2016.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 04/19/2016] [Accepted: 06/02/2016] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To evaluate the efficacy of L1-2ND in the management of the lower lip squamous cell carcinoma and to achieve the highest cure rates with adequate neck dissection. METHODS A retrospective review was completed on patients treated between 1994 and 2014. The case histories of 184 patients who were treated with surgical excision of the primary tumor along with neck dissection, and 24 patients who were treated only with surgical excision without neck dissection at another center, were studied. All patients were followed up for evidence of recurrent disease. RESULTS In 208 patients (193 men, 15 women) with a mean age of 51 years, 12 were N1, 3 were N2, and 169 were N0; 24 patients had undergone operation at another center without neck dissection. Lymph node metastases were present in 34 patients (18.4%) with dissected necks and occult metastases were detected in 19 patients with clinically N0 necks (11.2%). The median follow-up of each patient was 28 months. Only 1 patient developed neck recurrence, and there was no local recurrence. The overall survival rate (OAS) of patients with clinical N0 disease who underwent neck dissection was 94.7%; the OAS of the patients who were not treated with neck dissection was 29.1%. CONCLUSION Level 1-2 neck dissection (L1-2ND) is the treatment of choice for controlling neck disease in patients with lower lip carcinoma, and serves as a staging procedure to detect patients who require adjuvant therapy.
Collapse
Affiliation(s)
- Oguz Kuscu
- Hacettepe University, Department of Otorhinolaryngology, Head and, Neck Surgery, Turkey.
| | - Munir Demir Bajin
- Hacettepe University, Department of Otorhinolaryngology, Head and, Neck Surgery, Turkey.
| | - Nilda Süslü
- Hacettepe University, Department of Otorhinolaryngology, Head and, Neck Surgery, Turkey.
| | - Ali Şefik Hoşal
- Liv Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Turkey.
| |
Collapse
|
12
|
Denadai R, Raposo-Amaral CE, Buzzo CL, Raposo-Amaral CA. Functional lower lip reconstruction with the modified Bernard-Webster flap. J Plast Reconstr Aesthet Surg 2015; 68:1522-8. [PMID: 26243196 DOI: 10.1016/j.bjps.2015.07.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 07/06/2015] [Accepted: 07/12/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Lower lip defects after squamous cell carcinoma (SCC) excisions have been repaired by several surgical techniques. However, the functional reconstruction of full-thickness defects of the lower lip remains a therapeutic challenge. We therefore evaluated functional results of the modified Bernard-Webster flap for the reconstruction of full-thickness lower lip defects after SCC excisions. METHODS A prospective study was performed on all patients with lower lip full-thickness defects after SCC excisions greater than 1/3 of the lip, reconstructed with the modified Bernard-Webster flap in 2011-2013. Functional (sphincter, motor, and sensory functions) postoperative results were evaluated according to criteria previously adopted. RESULTS Twelve lower lip defects were reconstructed without complications, except for two (16.7%) wound dehiscence successfully managed. Ten (83.3%) patients presented transient and permanent functional abnormalities in the recent and late postoperative assessments. Ten (83.3%) patients classified the late functional results as satisfactory. CONCLUSIONS The modified Bernard-Webster flap proved to be an excellent alternative to repair full-thickness lower lip defects with more than 1/3 of the lower lip length, as it allowed the use of similar neighboring tissues, could be performed in one stage, and was functionally effective.
Collapse
Affiliation(s)
- Rafael Denadai
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil
| | | | - Celso Luiz Buzzo
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil
| | | |
Collapse
|
13
|
Jing G, Wu Y, Song H, Ren G, Wang R, Guo W. Primary Malignant Melanoma of the Lip: A Report of 48 Cases. J Oral Maxillofac Surg 2015; 73:2232-40. [PMID: 26047711 DOI: 10.1016/j.joms.2015.05.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/15/2015] [Accepted: 05/15/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE Lip melanoma (LM) is a rare malignant tumor and well-established treatment protocols for it are in short supply. The objective of this study was to evaluate the outcome of treatment modalities and explore the prognostic factors. PATIENTS AND METHODS A retrospective chart review was performed on 48 patients with primary LM treated in the authors' hospital from January 1992 to November 2013. The clinical characteristics and treatment modalities were identified and correlated with the outcomes. RESULTS The 5-year overall survival (OS) rate was 56.1%, and the rate of cervical lymph node (CLN) metastasis was 46% (22 of 48). A tumor of at least 4 cm (P = .001), nodular types (P = .003), and CLN (P < .0001) were independent prognostic factors for OS. Twenty-five patients died during follow-up, mainly from to neck recurrence (14 of 25). Chemotherapy significantly improved the 5-year OS rate in patients with stage IV LM (P = .03), but not in those with stage III (P = .8). CONCLUSIONS LM has a lower CLN and distant metastasis rate and a better prognosis than other oral mucosal melanomas. A long history of melanin pigmentation is a dangerous sign for all patients, and smoking seems to be associated with LM in male patients. Tumor size (≥4 cm), nodular type, and CLN positivity are poor prognostic factors. A wide excision with close observation is advocated as the primary treatment for stage III LM. Adjuvant chemotherapy is useful for patients with stage IV cancer, but not for those with stage III.
Collapse
Affiliation(s)
- Guangping Jing
- Associate Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Yunteng Wu
- Resident, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Hao Song
- Resident, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Guoxin Ren
- Associate Professor, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Runxiang Wang
- Resident, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Wei Guo
- Professor and Department Head, Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
| |
Collapse
|