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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.
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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
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Kansara S, Oral E, Sarkar I, Sandulache V, Mualla R, Walvekar RR, Ryan W, Ha P. Rate of occult metastasis in lip squamous cell carcinoma: A systematic review and meta-analysis. Head Neck 2024. [PMID: 38497534 DOI: 10.1002/hed.27747] [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: 12/05/2023] [Revised: 02/12/2024] [Accepted: 03/12/2024] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVES The rate of occult metastasis in lip cancer is poorly studied. Management of the regional nodal basin in lip cancer is thus controversial. This study sought to understand the true rate of micrometastasis in lip cancer. MATERIALS AND METHODS Systematic review and meta-analysis was conducted of English language studies reporting lip cancer sentinel node biopsy results. Studies were obtained from the PubMed database between the years 2000 and 2023 using the search terms "sentinel node biopsy" and "squamous cell carcinoma." Random effect and fixed effect meta-analyses were performed. RESULTS Thirteen studies met inclusion criteria. Low heterogeneity was noted among the studies, as indicated by the I2 inconsistency test (I2 = 0%). The rate of occult metastasis ranged between 0 and 33% (mean 9%). A total of 189 lip sentinel node biopsies had been performed. Of these, 21 revealed occult nodal metastasis (11.1%, 95% CI 7.36%-16.44%). One step, generalized linear mixed modeling revealed the true rate of occult nodal metastasis to be 10% (95% CI (0.0504, 0.1746), p < 0.0001). CONCLUSION The rate of occult metastasis in lip cancer approaches the threshold for elective management of the regional nodal basin. Sentinel node biopsy is optimally suited for management of high-risk early T stage lip cancer.
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Affiliation(s)
- Sagar Kansara
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Evrim Oral
- School of Public Health, Biostatistics and Data Science Program, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Indrani Sarkar
- School of Public Health, Biostatistics and Data Science Program, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Vlad Sandulache
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Rula Mualla
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Rohan R Walvekar
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - William Ryan
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Patrick Ha
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
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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.
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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
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Abstract
Lip and oral cavity squamous cell carcinoma (SCC) develop from progressive dysplasia of these mucosal structures. The cancers are often preceded by premalignant lesions, and any nonhealing ulcers of the lip or oral cavity should be biopsied. Some risk factors for these 2 subsites overlap and include tobacco use, alcohol use, and an immunocompromised state. Lip and oral cavity SCC are clinically staged based on physical examination and imaging. The 5-year overall survival for early-stage lip and oral cavity SCC is around 70% to 90% but decreases to about 50% for late-stage disease.
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El Ayachy R, Sun R, Ka K, Laville A, Duhamel AS, Tailleur A, Dumas I, Bockel S, Espenel S, Blanchard P, Tao Y, Temam S, Moya-Plana A, Haie-Meder C, Chargari C. Pulsed Dose Rate Brachytherapy of Lip Carcinoma: Clinical Outcome and Quality of Life Analysis. Cancers (Basel) 2021; 13:cancers13061387. [PMID: 33808535 PMCID: PMC8003123 DOI: 10.3390/cancers13061387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 01/04/2023] Open
Abstract
Simple Summary Lip cancer accounts for 25–30% of all oral cancers, with 23,000 new cases per year in the world. Carcinomas of the lip can be successfully treated with different methods: surgery, external beam radiotherapy (EBRT) and brachytherapy. The choice of the treatment depends on the tumor size, location and expected functional and esthetic results with each option, but also depends on treatment type accessibility. There are no randomized studies comparing these different treatment strategies. In this article, we investigated the complications and outcomes of patients treated with interstitial pulsed dose rate brachytherapy in our institution. Abstract Purpose: Lip carcinoma represents one of the most common types of head and neck cancer. Brachytherapy is a highly effective therapeutic option for all stages of lip cancers. We report our experience of pulsed dose rate brachytherapy (PDR) as treatment of lip carcinoma. Methods and Materials: this retrospective single center study included all consecutive patients treated for a lip PDR brachytherapy in our institution from 2010 to 2019. The toxicities and outcomes of the patients were reported, and a retrospective quality of life assessment was conducted by phone interviews (FACT H&N). Results: From October 2010 to December 2019, 38 patients were treated in our institution for a lip carcinoma by PDR brachytherapy. The median age was 73, and the majority of patients presented T1-T2 tumors (79%). The median total dose was 70.14 Gy (range: 60–85 Gy). With a mean follow-up of 35.4 months, two patients (5.6%) presented local failure, and seven patients (19%) had lymph node progression. The Kaplan–Meier estimated probability of local failure was 7.2% (95% CI: 0.84–1) at two and four years. All patients encountered radiomucitis grade II or higher. The rate of late toxicities was low: three patients (8.3%) had grade II fibrosis, and one patient had grade II chronic pain. All patients would highly recommend the treatment. The median FACT H&N total score was 127 out of 148, and the median FACT H&N Trial Outcome Index was 84. Conclusions: This study confirms that an excellent local control rate is achieved with PDR brachytherapy as treatment of lip carcinoma, with very limited late side effects and satisfactory functional outcomes. A multimodal approach should help to improve regional control.
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Affiliation(s)
- Radouane El Ayachy
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Roger Sun
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Kanta Ka
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Adrien Laville
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Anne-Sophie Duhamel
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Anne Tailleur
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Isabelle Dumas
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Sophie Bockel
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Sophie Espenel
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Pierre Blanchard
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Yungan Tao
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Stéphane Temam
- Head and Neck Surgery Department, Gustave Roussy, 94800 Villejuif, France; (S.T.); (A.M.-P.)
| | - Antoine Moya-Plana
- Head and Neck Surgery Department, Gustave Roussy, 94800 Villejuif, France; (S.T.); (A.M.-P.)
| | - Christine Haie-Meder
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
- Centre de Cancérologie, Département d’Oncologie Radiothérapie, Charlebourg la Défense, 92250 La Garenne Colombes, France
| | - Cyrus Chargari
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
- INSERM1030 Radiothérapie Moléculaire et Innovations Thérapeutiques, Université Paris-Saclay, 94800 Villejuif, France
- Correspondence:
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Park JI, Lee S, Kim IH, Ye SJ. Artifact-free CT images for electron beam therapy using a patient-specific non metallic shield. Phys Med 2020; 75:92-99. [PMID: 32559651 DOI: 10.1016/j.ejmp.2020.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 05/10/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022] Open
Abstract
Patient's CT images taken with metallic shields for radiotherapy suffer from artifacts. Furthermore, the treatment planning system (TPS) has a limitation on accurate dose calculations for high density materials. In this study, a Monte Carlo (MC)-based method was developed to accurately evaluate the dosimetric effect of the metallic shield. Two patients with a commercial tungsten shield of lens and two patients with a custom-made lead shield of lip were chosen to produce their non-metallic dummy shields using 3D scanner and printer. With these dummy shields, we generated artifact-free CT images. The maximum CT number allowed in TPS was assigned to metallic shields. MC simulations with real material information were carried out. In addition, clinically relevant dose-volumetric parameters were calculated for the comparison between MC and TPS. Relative dosimetry was performed using radiochromic films. The dose reductions below metallic structures were shown on MC dose distributions, but not evident on TPS dose distributions. The differences in dose-volumetric parameters of PTV between TPS and MC for eye shield cases were not clearly shown. However, the mean dose of lens from TPS and MC was different. The MC results were in superior agreement with measured data in relative dosimetry. The lens dose could be overestimated by TPS. The differences in dose-volumetric parameters of PTV between TPS and MC were generally larger in lip cases than in eye cases. The developed method is useful in predicting the realistic dose distributions around the organs blocked by the metallic shields.
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Affiliation(s)
- Jong In Park
- Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea.
| | - Sangmin Lee
- Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Il Han Kim
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, South Korea
| | - Sung-Joon Ye
- Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea; Department of Radiation Oncology, Seoul National University Hospital, Seoul, South Korea; Robotics Research Laboratory for Extreme Environment, Advanced Institutes of Convergence Technology, Seoul National University, Suwon, Gyeonggi-do, South Korea
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Walton E, Cramer JD. Predictors of occult lymph node metastases in lip cancer. Am J Otolaryngol 2020; 41:102419. [PMID: 32081379 DOI: 10.1016/j.amjoto.2020.102419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 02/03/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The incidence of lymph node metastases (LNM) in squamous cell carcinoma of the lip is modest (8%), making it challenging to identify patients that may benefit from elective pathologic staging evaluation of the neck. We evaluated predictors of LNM in patients with lip cancer in order to potentially refine selection of patients for pathologic staging evaluation of the neck. STUDY DESIGN Retrospective cohort study. SUBJECTS Clinically N0 patients with squamous cell carcinoma of the lip that underwent definitive surgical resection and pathologic evaluation of lymph node metastases in the National Cancer Data Base from 2006 to 2013. METHODS Multivariable binomial logistic-regression was used to assess the relationship between occult pathologic lymph node metastasis and potential preoperative predictors including; patient demographics, T-stage, location, and pathologic details. RESULTS Among 786 patients the overall rate of LNM was 12.1%. Patients were more likely to have LNM with T2 (odds ratio (OR) 2.05; (95% confidence interval (CI) 1.19-3.54) or T3-4 (OR 2.36; CI 1.32-4.22) moderately differentiated (OR 2.65; CI 1.30-5.38) or poorly differentiated (OR 4.37; CI 1.97-9.71), or involvement of the mucosal surface (OR 1.82; CI 1.09-3.03). We created a prediction model based on proportional odd ratios from multivariant binomial logistic-regression analysis from statistically significant factors; incorporating T2-4, moderate/poorly differentiated, or mucosal site. CONCLUSION Our prediction model found that patients with two or more risk factors were the best candidates for elective pathologic nodal evaluation.
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Affiliation(s)
- Edward Walton
- Department of General Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - John D Cramer
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA.
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Predictive factors for late cervical metastasis in stage I and II squamous cell carcinoma of the lip. Eur Arch Otorhinolaryngol 2019; 276:2047-2053. [DOI: 10.1007/s00405-019-05457-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/30/2019] [Indexed: 10/26/2022]
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9
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de Sena LSB, da Silveira ÉJD, Batista AC, Mendonça EF, Alves PM, Nonaka CFW. Immunoexpression of glucocorticoid receptor alpha (GRα) isoform and apoptotic proteins (Bcl-2 and Bax) in actinic cheilitis and lower lip squamous cell carcinoma. J Oral Pathol Med 2018; 47:788-795. [DOI: 10.1111/jop.12757] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 06/21/2018] [Indexed: 12/31/2022]
Affiliation(s)
| | | | - Aline Carvalho Batista
- Department of Stomatology (Oral Pathology); Dental School; Federal University of Goiás; Goiânia Brazil
| | | | - Pollianna Muniz Alves
- Postgraduate Program in Dentistry; Dental School; State University of Paraíba; Campina Grande PB Brazil
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Tseng HW, Liou HH, Tsai KW, Ger LP, Shiue YL. Clinicopathological study of lip cancer: a retrospective hospital-based study in Taiwan. APMIS 2017; 125:1007-1016. [PMID: 28913905 DOI: 10.1111/apm.12751] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 07/17/2017] [Indexed: 11/30/2022]
Abstract
To evaluate the clinicopathological characteristics, high-risk lifestyle factors (HRLF: chronic exposure to sun, betel quid, alcohol, and tobacco), and prognostic factors of lip cancer. The hospital records of patients with pathologically confirmed lip squamous cell carcinoma (LSCC, n = 112) and lip basal cell carcinoma (LBCC, n = 21) were reviewed. Differences in clinicopathological characteristics between LSCC and LBCC, upper and lower lip, and status of second primary tumors were compared by chi-square test and logistic regression. The prognostic factors for LSCC were analyzed by Cox regression. Compared with LBCC patients, LSCC patients were men-predominant (p < 0.001), had younger ages at onset (p < 0.001), and higher rates of lower lips involvement (p < 0.001) and HRLFs. Patients with second primary tumors were highly associated with lower lip cancer involvement (adjusted odds ratio = 2.91, p = 0.03). Patients with lower lip cancer had more HRLFs with an increasing linear trend (p = 0.004). The poorer prognostic factors of LSCC for disease-specific survival were advanced stage III/IV [crude hazard ratio (CHR) = 11.16, p < 0.001], tumor dimension >4 cm (CHR = 8.19, p = 0.006), lymph node involvement (CHR = 11.48, p < 0.001), and recurrence (CHR = 3.96, p = 0.01); whereas for disease-free survival were moderately to poorly differentiated LSCC (CHR = 4.97, p = 0.002) and alcohol consumption (CHR = 3.13, p = 0.04). LSCC and lower lip cancer were highly associated with HRLFs.
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Affiliation(s)
- Hui-Wen Tseng
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Huei-Han Liou
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Kuo-Wang Tsai
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Luo-Ping Ger
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.,Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yow-Ling Shiue
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
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11
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Agostini T, Spinelli G, Arcuri F, Perello R. Metastatic Squamous Cell Carcinoma of the Lower Lip: Analysis of the 5-Year Survival Rate. Arch Craniofac Surg 2017; 18:105-111. [PMID: 28913316 PMCID: PMC5556890 DOI: 10.7181/acfs.2017.18.2.105] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/19/2017] [Accepted: 06/20/2017] [Indexed: 11/21/2022] Open
Abstract
Objectives The author analyse the impact of extracapsular lymph node spread and bone engagement in the ipsilateral neck of patients suffering squamous cell carcinoma (SCC) of the lower lip. Methods The data of 56 neck dissections performed in patients suffering SCC of the lower lip between January 2000 and December 2008 were retrospectively analysed. Statistical analysis was performed with the Kaplan-Meier life table method, and the survival rate was investigated with the log rank statistic and significance test. The values were considered statistically significant at p<0.05. Results Nine patients took advantage from simultaneous treatment of tumor and prophylactic neck dissection (level I-III), reaching 100% survival rate. Patients suffering metastasized disease, who received radical neck dissection at the time of tumor treatment, presented 83.3% survival rate. Patients who underwent previous surgery and radiotherapy presented worse prognosis although radical neck dissection in case of extra-capsular spread only (24.7%) and osseous engagement (22.2%). Conclusion Prophylactic neck dissection (level I–III) is recommended in T3–T4 N0 SCC. Simultaneous treatment of tumor and cervical lymph nodes provides a better prognosis as respect to delayed nodal management. Extra-capsular spread with or without bone engagement represents independent risk factor responsible for high mortality rate of SCC of the lower lip.
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Affiliation(s)
- Tommaso Agostini
- Department of Maxillo-Facial Surgery, CTO-AOUC, University of Florence, Florence, Italy.,Department of Plastic and Reconstructive Surgery, Centro Chirurgico San Paolo, Pistoia, Italy
| | - Giuseppe Spinelli
- Department of Maxillo-Facial Surgery, CTO-AOUC, University of Florence, Florence, Italy
| | - Francesco Arcuri
- Department of Maxillo-Facial Surgery, CTO-AOUC, University of Florence, Florence, Italy
| | - Raffaella Perello
- Department of Plastic and Reconstructive Surgery, Centro Chirurgico San Paolo, Pistoia, Italy
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12
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Dougherty W, Givi B, Jameson MJ. AHNS Series - Do you know your guidelines? Lip cancer. Head Neck 2017; 39:1505-1509. [DOI: 10.1002/hed.24817] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 04/04/2017] [Indexed: 11/09/2022] Open
Affiliation(s)
- William Dougherty
- Department of Otolaryngology - Head and Neck Surgery; University of Virginia Health System; Charlottesville Virginia
| | - Babak Givi
- Department of Otolaryngology - Head and Neck Surgery; New York University Langone Medical Center; New York New York
| | - Mark J. Jameson
- Department of Otolaryngology - Head and Neck Surgery; University of Virginia Health System; Charlottesville Virginia
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13
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Squamous Cell Carcinoma of the Lip—A Review of Squamous Cell Carcinogenesis of the Mucosal and Cutaneous Junction. Dermatol Surg 2017; 43:494-506. [DOI: 10.1097/dss.0000000000001020] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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14
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Cernea SS, Gontijo G, Pimentel ERDA, Tarlé RG, Tassara G, Ferreira JADSLB, Fernandes VMC, Bernardo WM. Indication guidelines for Mohs micrographic surgery in skin tumors. An Bras Dermatol 2016; 91:621-627. [PMID: 27828636 PMCID: PMC5087221 DOI: 10.1590/abd1806-4841.20164808] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 09/27/2016] [Indexed: 01/02/2024] Open
Abstract
Mohs micrographic surgery is a technique used to excise skin tumors based on comprehensive surgical mapping, in which the surgeon removes the tumor, followed by a complete histological evaluation of the tumor's margins. The correlation of the presence of a tumor in histological examinations and its precise location on the surgical map result in a complete removal of the tumor with maximum normal tissue preservation. The present article seeks to provide general practitioners and healthcare specialists with guidelines regarding recommendations for Mohs micrographic surgery to treat skin tumors, based on the most reliable evidence available in medical literature on the subject. This bibliographic review of scientific articles in this line of research was conducted based on data collected from MEDLINE/PubMed. The search strategy used in this study was based on structured questions in the Patient, Intervention, Control, and Outcome (PICO) format. MeSH terms were used as descriptors. The indications of this technique are related to recurrence, histology, size, definition of tumor margins, and location of tumors. These guidelines attempt to establish the indications of Mohs surgery for different types of skin tumors.
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Affiliation(s)
| | - Gabriel Gontijo
- Universidade Federal de Minas Gerais (UFMG), Belo
Horizonte, MG, Brazil
| | | | | | - Glaysson Tassara
- Universidade Federal de Minas Gerais (UFMG), Belo
Horizonte, MG, Brazil
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15
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Gomes JO, de Vasconcelos Carvalho M, Fonseca FP, Gondak RO, Lopes MA, Vargas PA. CD1a+ and CD83+ Langerhans cells are reduced in lower lip squamous cell carcinoma. J Oral Pathol Med 2016; 45:433-9. [PMID: 26661374 DOI: 10.1111/jop.12389] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Actinic cheilitis (AC) is a potentially malignant lesion diagnosed in the lip of patients chronically exposed to the sun that may give rise to a fully invasive lower lip squamous cell carcinoma (LLSCC). It is known that ultraviolet radiation causes dendritic cells (DCs) depletion in the epidermis, but the role of this cellular population in lip cancer progression remains uncertain. Therefore, this study investigated the distribution of DCs in normal, dysplastic and neoplastic tissues of the lower lip. METHODS Thirteen cases of lower lip mucocele, 42 of ACs and 21 of LLSCC were retrieved and original diagnoses confirmed by two oral pathologists, who further classified ACs as low- and high-risk lesions. Immunoreactions against CD1a and CD83 identified immature and mature DCs, respectively. RESULTS Immature CD1a+ Langerhans cells (LCs) were significantly decreased in LLSCC when compared to morphologically normal (P < 0.009) and dysplastic epitheliums (P < 0.003), whereas mature CD83+ LCs were significantly decreased in LLSCC when compared to normal epithelium (P = 0.038). There was no significant difference between low- and high-risk ACs regarding CD1a+ and CD83+ LCs (P > 0.05), but ACs demonstrated a lower concentration of CD1a+ LCs than normal epithelium (P < 0.009). There was no significant difference in the distribution of CD1a+ and CD83+ interstitial dendritic cells (IDCs) in the connective tissue among the studied groups (P > 0.05). CONCLUSION These results suggest that depletion of epithelial LCs, but not IDCs in the connective tissue, would represent an important step for lip cancer development.
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Affiliation(s)
| | | | | | | | | | - Pablo Agustin Vargas
- Department of Oral Diagnosis, University of Campinas, Piracicaba, Brazil
- Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa
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16
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LÚCIO PSC, RIBEIRO DC, AGUIAR MCFD, ALVES PM, NONAKA CFW, GODOY GP. Tumor-associated macrophages (TAMs): clinical-pathological parameters in squamous cell carcinomas of the lower lip. Braz Oral Res 2016; 30:e95. [DOI: 10.1590/1807-3107bor-2016.vol30.0095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 06/07/2016] [Indexed: 12/19/2022] Open
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17
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Pietersma N, de Bock G, de Visscher J, Roodenburg J, van Dijk B. No evidence for a survival difference between upper and lower lip squamous cell carcinoma. Int J Oral Maxillofac Surg 2015; 44:549-54. [DOI: 10.1016/j.ijom.2014.10.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 10/30/2014] [Accepted: 10/30/2014] [Indexed: 11/24/2022]
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18
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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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19
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Miyazaki H, Makiguchi T, Takayama Y, Yokoo S. Lower lip repair using double opposing rectangular rotation flaps with reconstruction of the mentolabial groove and mental protuberance. Int J Oral Maxillofac Surg 2014; 43:1073-5. [PMID: 24997680 DOI: 10.1016/j.ijom.2014.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 04/14/2014] [Accepted: 06/04/2014] [Indexed: 11/18/2022]
Abstract
The use of a rectangular flap is a well known technique for upper lip repair in cleft lip, but is less common for lower lip repair after tumour resection. We have found this type of flap to be favourable for lower lip reconstruction, especially for the lip to mental region. We describe herein an improvement to the technique in which two opposing rectangular flaps, with the length of one side equal to the vertical distance from the mentolabial groove to the vermilion border, were raised on the lateral sides of a U-shaped defect. Reconstruction was performed by interdigitation of the two flaps and a bilateral vermilion advancement flap. This new approach allows a distinct mentolabial groove and mental protuberance to be created by utilizing two opposing rectangular flaps and redundant tissue, without sacrificing sensation and muscle function. Our results suggest that the technique provides excellent functional and cosmetic outcomes in restoration of the lower lip in properly selected patients.
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Affiliation(s)
- H Miyazaki
- Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma, Japan.
| | - T Makiguchi
- Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Y Takayama
- Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
| | - S Yokoo
- Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma, Japan
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20
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Histopathological grading systems and their relationship with clinical parameters in lower lip squamous cell carcinoma. Int J Oral Maxillofac Surg 2014; 43:539-45. [DOI: 10.1016/j.ijom.2013.10.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 09/07/2013] [Accepted: 10/21/2013] [Indexed: 01/09/2023]
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Abstract
The purpose of this article is to review the common neoplasms, infections, and inflammatory dermatoses that may present around or near the mouth. Dental professionals are well positioned to evaluate perioral skin conditions, further contributing to patients' general health. This article includes a review of seborrheic keratosis, warts, actinic keratoses, actinic cheilitis, and squamous cell carcinoma, among several other perioral cutaneous lesions.
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Affiliation(s)
- Geoffrey F S Lim
- Department of Dermatology, Drexel University College of Medicine, The Arnold T. Berman, M.D. Building, 219 North Broad Street, Philadelphia, PA 19107, USA.
| | - Carrie Ann R Cusack
- Department of Dermatology, Drexel University College of Medicine, The Arnold T. Berman, M.D. Building, 219 North Broad Street, Philadelphia, PA 19107, USA
| | - Joseph M Kist
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, South Pavilion, 1st Floor, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
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22
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Guinot JL, Arribas L, Vendrell JB, Santos M, Tortajada MI, Mut A, Cruz J, Mengual JL, Chust ML. Prognostic factors in squamous cell lip carcinoma treated with high-dose-rate brachytherapy. Head Neck 2014; 36:1737-42. [DOI: 10.1002/hed.23529] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2013] [Indexed: 11/09/2022] Open
Affiliation(s)
- Jose-Luis Guinot
- Department of Radiation Oncology; Fundacion Instituto Valenciano de Oncologia (I.V.O.); Valencia Spain
| | - Leoncio Arribas
- Department of Radiation Oncology; Fundacion Instituto Valenciano de Oncologia (I.V.O.); Valencia Spain
| | - Juan B. Vendrell
- Department of Head and Neck Surgery; Fundacion Instituto Valenciano de Oncologia (I.V.O.); Valencia Spain
| | - Miguel Santos
- Department of Radiation Oncology; Fundacion Instituto Valenciano de Oncologia (I.V.O.); Valencia Spain
| | - Maria I. Tortajada
- Department of Radiation Oncology; Fundacion Instituto Valenciano de Oncologia (I.V.O.); Valencia Spain
| | - Alejandro Mut
- Department of Radiation Oncology; Fundacion Instituto Valenciano de Oncologia (I.V.O.); Valencia Spain
| | - Julia Cruz
- Department of Pathology; Fundacion Instituto Valenciano de Oncologia (I.V.O.); Valencia Spain
| | - Jose L. Mengual
- Department of Radiation Oncology; Fundacion Instituto Valenciano de Oncologia (I.V.O.); Valencia Spain
| | - Maria L. Chust
- Department of Radiation Oncology; Fundacion Instituto Valenciano de Oncologia (I.V.O.); Valencia Spain
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23
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Guinot JL, Arribas L, Tortajada MI, Crispín V, Carrascosa M, Santos M, Mut A, Vendrell JB, Pesudo C, Chust ML. From low-dose-rate to high-dose-rate brachytherapy in lip carcinoma: Equivalent results but fewer complications. Brachytherapy 2013; 12:528-34. [DOI: 10.1016/j.brachy.2013.05.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 04/27/2013] [Accepted: 05/02/2013] [Indexed: 10/26/2022]
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24
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Immunoexpression of claudin-1 and Nm23-H1 in metastatic and nonmetastatic lower lip squamous-cell carcinoma. Appl Immunohistochem Mol Morphol 2013; 20:595-601. [PMID: 22531683 DOI: 10.1097/pai.0b013e3182505c22] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to evaluate the immunoexpression of claudin-1 and Nm23-H1 in metastatic and nonmetastatic lower lip squamous-cell carcinoma (LLSCC). Twenty LLSCCs with regional nodal metastasis and 20 LLSCCs without metastases were selected. The percentage of claudin-1 staining and the staining intensity and percentage of Nm23-H1 staining in each tumor core were assessed. Metastatic tumors exhibited higher expression of claudin-1 than nonmetastatic tumors (P = 0.030). Similarly, stage III and IV LLSCCs showed higher expression of claudin-1 than stages I and II (P = 0.026). The percentage of claudin-1 staining was scored as 2 in most well-differentiated and moderately differentiated tumors, whereas poorly differentiated tumors showed a relatively similar distribution of scores 2, 1, and 0 (P = 0.648). Regarding Nm23-H1, there was a predominance of negative cases for both metastatic and nonmetastatic tumors (P = 0.235). In addition, no significant differences in the percentage of Nm23-H1-negative and Nm23-H1-positive cases were observed regarding the clinical staging (P = 0.430) and the histologic grading of malignancy (P = 0.702). The results of this study suggest an important role of claudin-1 in the development of metastasis in LLSCCs. In contrast, the present findings do not support a significant role of Nm23-H1 in metastasis suppression of LLSCC.
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25
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Shokrani P, Baradaran-Ghahfarokhi M, Zadeh MK. A novel approach in electron beam radiation therapy of lips carcinoma: A Monte Carlo study. Med Phys 2013; 40:041720. [DOI: 10.1118/1.4795756] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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26
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Vieira RAMAR, Minicucci EM, Marques MEA, Marques SA. Actinic cheilitis and squamous cell carcinoma of the lip: clinical, histopathological and immunogenetic aspects. An Bras Dermatol 2012; 87:105-14. [DOI: 10.1590/s0365-05962012000100013] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 02/23/2011] [Indexed: 11/22/2022] Open
Abstract
Actinic cheilitis is the main precancerous lesion of the lip. Squamous cell carcinoma of the lip is reported together with oral carcinomas in the Brazilian official statistics. Overall, they account for 40% of the head and neck carcinomas. In general, physicians and dentists know little about what causes oral tumor development and progression. Tumor suppressor genes and cell proliferation regulatory proteins play a role in the progression of actinic cheilitis to squamous cell carcinoma and in its biological behavior. Knowledge on prognostic and diagnostic markers has a positive impact on the follow-up of these patients.
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27
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Jadotte YT, Schwartz RA. Solar cheilosis: An ominous precursor. J Am Acad Dermatol 2012; 66:187-98; quiz 199-200. [DOI: 10.1016/j.jaad.2011.09.039] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 08/31/2011] [Accepted: 09/04/2011] [Indexed: 11/15/2022]
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Géraud C, Koenen W, Neumayr L, Doobe G, Schmieder A, Weiss C, Goerdt S, Faulhaber J. Lip cancer: retrospective analysis of 181 cases. J Dtsch Dermatol Ges 2011; 10:121-7. [PMID: 22136191 DOI: 10.1111/j.1610-0387.2011.07853.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In Germany little data on the epidemiology and histology of lip cancers are available, as lip cancers are commonly pooled together with head and neck tumors. PATIENTS AND METHODS Retrospective analysis of 181 patients with malignant tumors of the lips with respect to gender, location, histology, risk factors and comorbidity. RESULTS There were 90 women and 91 men with a mean age of 71 years. 98 had a tumor on the upper lip and 83 patients on the lower lip. Tumors of the upper lip showed a slight female preference (61%). In contrast lower lip cancer was more common (64%) in men. Histological analysis revealed that in both regions nodular basal cell carcinomas as well as squamous cell carcinomas (NOS) are the most common subtypes. Vertical tumor thickness of squamous cell carcinomas was in most cases smaller than 6 mm (n = 71) and only in 4 cases was a tumor thickness of >6 mm detected. Altogether, 57% of the patients reported a high to very high sun exposure. CONCLUSIONS In comparison to previous studies we found a weaker preference for women for tumors of the upper lip and also a weaker preference for men for tumors of the lower lip. The causes remain unclear, but could be causally related to an increased life expectancy and/or changed risk profile.
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Affiliation(s)
- Cyrill Géraud
- Department of Dermatology, Venereology and Allergology, University Medicine Mannheim, Medical Faculty of the University of Heidelberg, Mannheim, Germany
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Faulhaber J, Géraud C, Goerdt S, Koenen W. Functional and Aesthetic Reconstruction of Full-Thickness Defects of the Lower Lip After Tumor Resection: Analysis of 59 Cases and Discussion of a Surgical Approach. Dermatol Surg 2010; 36:859-67. [PMID: 20618371 DOI: 10.1111/j.1524-4725.2010.01561.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jörg Faulhaber
- Department of Dermatology, University Medical Center Mannheim, Ruprecht-Karls University Heidelberg, Mannheim, Germany
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30
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Yilmaz S, Ercocen AR. Is elective neck dissection in T1-2, N0 patients with lower lip cancer necessary? Ann Plast Surg 2009; 62:381-3. [PMID: 19325341 DOI: 10.1097/sap.0b013e318184ab14] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The significance of elective neck dissection in the early stages of lower lip cancer is generally underestimated. In the classic textbooks of plastic surgery it has been generally accepted that lymphatic spread to neck is negligible and therefore it is not imperative to perform any kind of neck dissection. However, in some recent studies high rates of clinically positive neck that were initially negative began to appear in the literature especially in otorhinolaryngology and head and neck journals. Our clinical series consisted of 21 lower lip cancer cases with T1-2, N0 tumors; the rate of lymphatic spread to neck was found to be 19%. Because of this high rate, we conclude that it is not sound to discard the importance of neck dissection even in the early stages of lower lip cancers. At least, a suprahyoid neck dissection should be performed in all patients with lower lip cancer.
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Affiliation(s)
- Sarper Yilmaz
- Department of Plastic and Reconstructive Surgery, Medical Faculty, Cumhuriyet University, Sivas, Turkey.
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31
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de Godoy Peres FF, Aigotti Haberbeck Brandão A, Rodarte Carvalho Y, Dória Filho U, Plapler H. A study of actinic cheilitis treatment by two low-morbidity CO2 laser vaporization one-pass protocols. Lasers Med Sci 2008; 24:375-85. [DOI: 10.1007/s10103-008-0574-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2007] [Accepted: 05/15/2008] [Indexed: 10/22/2022]
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33
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Leibovitch I, Huilgol SC, Selva D, Paver R, Richards S. Cutaneous lip tumours treated with Mohs micrographic surgery: clinical features and surgical outcome. Br J Dermatol 2005; 153:1147-52. [PMID: 16307650 DOI: 10.1111/j.1365-2133.2005.06903.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Australian Mohs micrographic surgery (MMS) database was initiated in 1993 by the Skin and Cancer Foundation Australia (SCFA) with the aim of collecting prospective data, and involved all Mohs surgeons in the country. OBJECTIVES To present a large series of patients with cutaneous lip tumours treated with MMS in Australia between 1993 and 2002. METHODS This prospective multicentre case series included all patients with cutaneous lip tumours who were monitored by the SCFA. The main outcome measures were patient demographics, reason for referral, duration of tumour, site, preoperative tumour size and postoperative defect size, recurrences prior to MMS, histological subtypes, perineural invasion and 5-year recurrence after MMS. RESULTS There were 581 patients (66.1% women and 33.9% men, P < 0.0001) with a mean +/- SD age of 58 +/- 15 years. The upper lip was the most common site involved (81.1%). Basal cell carcinoma (BCC) was diagnosed in 82.3%, squamous cell carcinoma (SCC) in 16.5%, Bowen's disease (BD) in 0.7% and microcystic adnexal carcinoma (MAC) in 0.5% of cases. BCC was more common on the upper lip and in women, whereas SCC was more common on the lower lip and in men (P < 0.0001). Most upper lip tumours occurred in women (75.4%), whereas most lower lip tumours occurred in men (73.6%). SCC was associated with a larger tumour and postoperative defect size compared with the other tumours. The 5-year recurrence for BCC was 3.0%, and there were no cases of recurrence for SCC, BD or MAC. CONCLUSIONS BCC was the most common cutaneous lip tumour managed by MMS, and was significantly more common on the upper lip and in women. The low 5-year recurrence rate emphasizes the importance of margin-controlled excision.
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Affiliation(s)
- I Leibovitch
- Oculoplastic and Orbital Division, Department of Ophthalmology and Visual Sciences, Royal Adelaide Hospital, University of Adelaide, South Australia.
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34
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Somma P, Lo Muzio L, Mansueto G, Delfino M, Fabbrocini G, Mascolo M, Mignogna C, Di Benedetto M, Carinci F, De Lillo A, Pastore L, Serpico R, De Rosa G, Staibano S. Squamous cell carcinoma of the lower lip: FAS/FASL expression, lymphocyte subtypes and outcome. Int J Immunopathol Pharmacol 2005; 18:59-64. [PMID: 15698511 DOI: 10.1177/039463200501800107] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Squamous cell carcinoma (SCC) of the lip is a relatively common malignancy of the head and neck region. Tumour thickness, grading and perineural invasion are significant prognostic indicators. However, there is still the need of new reliable biological markers able to predict the prognosis of the single cases with an unfavourable biological behaviour unpredictable by the classic clinical-pathological parameters. 32 cases of (SCC) of the lower lip were analysed for their clincopathologic features, and immunohistochemical expression of Fas/FasL in neoplastic cells and in inflammatory infiltrate. Moreover the density and phenotype of tumour-infiltrating lymphocytes (TIL) were analysed. The results were related with the follow-up of the patients ranging from 2 to 6 years. The cases with over-expression of Fas/FasL in neoplastic cells and Fas+ in T cells preferentially showed a more aggressive clinical behaviour (P<0.01). Moreover we found an alteration of the normal expression of CD4 and CD8 lymphocyte types in ten cases. This data suggest that the Fas/FasL pathway is involved in the close relation between neoplastic cells and T cells and so in the biological behaviour of these tumours.
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Affiliation(s)
- P Somma
- Department of Biomorphologic and Functional Sciences, Section of Pathology. University of Naples Federico II, Naples, Italy
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