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van Hof KS, Wakkee M, Sewnaik A, Herkendaal AF, Tans L, Mast H, van den Bos RR, Mureau MAM, Offerman MPJ, Baatenburg de Jong RJ. Long-term outcomes, quality of life, and costs of treatment modalities for T1-T2 lip carcinomas. Oral Dis 2024; 30:2063-2074. [PMID: 37650356 DOI: 10.1111/odi.14723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/11/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Early stage lip squamous cell carcinoma (lip SCC) can be treated with conventional excision, Mohs micrographic surgery (MMS), or brachytherapy. The aim of this retrospective study was to describe the medical outcomes, patient-reported outcomes, and costs of these treatments. METHODS A retrospective cohort study of T1-T2 lip SSCs treated between 1996 and 2019. Medical outcomes, recurrences, and survival were retrieved from medical records. Facial appearance, facial function, and Quality of Life (QoL) were measured with the Face-Q H&N and EQ-5D-5L questionnaires. Costs were also calculated. RESULTS Of the 336 lip SCCs, 122 were treated with excision, 139 with MMS, and 75 with brachytherapy. Locally, the recurrence rate was 2.7% and regionally 4.8%. There were 2% disease-related deaths. T2-stage and poor tumor differentiation were associated with recurrences. Posttreatment QoL, facial function, and appearance were rated as good. Brachytherapy was the most expensive treatment modality. CONCLUSION Early-stage lip SCC has a good prognosis, with a disease-specific survival of 98.2% after a median follow-up of 36 months, there was a high QoL and satisfaction at long-term follow-up. Based on the costs and the risk of locoregional recurrences, we believe that, for most noncomplex lip SCCs, MMS would be the most logical treatment option.
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Affiliation(s)
- Kira S van Hof
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Marlies Wakkee
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Aniel Sewnaik
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Aimée F Herkendaal
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Lisa Tans
- Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Hetty Mast
- Department of Oral and Maxillofacial Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Renate R van den Bos
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Marc A M Mureau
- Department of Plastic & Reconstructive Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Marinella P J Offerman
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
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Sharp K, Olafsdottir EJ, Sahni DR, Madsen S, Grant-Kels JM, Kristjansson A, Hoyt DW, Ungar JP, Frigerio A, Jonasson JG, Adalsteinsson JA. Survival of patients with basal cell carcinoma, squamous cell carcinoma, and squamous cell carcinoma in situ: A whole population study. J Am Acad Dermatol 2024; 90:91-97. [PMID: 37758026 DOI: 10.1016/j.jaad.2023.09.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/25/2023] [Accepted: 09/10/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Keratinocyte carcinoma (KC) is the commonest type of malignancy in humans; however, the impact of KC on survival is poorly understood. OBJECTIVES This study characterizes the impact of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and squamous cell carcinoma in situ (SCCis) on the survival of Icelanders. METHODS This whole population study evaluated relative survival of KC in Iceland by using a cancer registry containing records of all BCC, SCCis, and SCC cases recorded in Iceland between 1981 and 2015. RESULTS Between 1981 and 2015, 8767 Icelanders were diagnosed with their first localized KC. A total of 6473 individuals with BCC, 1194 with SCCis, and 1100 with invasive SCC, respectively. BCC was not associated with decreased survival except for men diagnosed with BCC between 1981 and 1995 for whom decreased 10-year relative survival was observed (85.3, 95% CI [77.9-92.7]). SCC and SCCis were both associated with a decrease in relative survival for certain population subgroups such as individuals <50 years of age at time of diagnosis. CONCLUSION Our whole population cohort survival study examining the Icelandic Cancer Registry supports prior studies demonstrating that BCC is not associated with a reduction in relative survival and that SCC and SCCis are associated with comparatively poor relative survival in certain population subgroups.
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Affiliation(s)
- Kelley Sharp
- Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, Connecticut.
| | | | - Dev R Sahni
- Department of Dermatology, University of Utah Health, Salt Lake City, Utah
| | - Steve Madsen
- Department of Dermatology, University of Connecticut, Farmington, Connecticut
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut, Farmington, Connecticut
| | - Arni Kristjansson
- Faculty of Medicine, Department of Pathology, University of Iceland, Reykjavik, Iceland
| | - David W Hoyt
- Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah
| | - Jonathan P Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York City, New York
| | - Alice Frigerio
- Department of Dermatology, University of Utah Health, Salt Lake City, Utah
| | - Jon Gunnlaugur Jonasson
- Faculty of Medicine, Department of Pathology, University of Iceland, Reykjavik, Iceland; Department of Pathology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Jonas A Adalsteinsson
- Department of Dermatology, University of Utah Health, Salt Lake City, Utah; Faculty of Medicine, Department of Pathology, University of Iceland, Reykjavik, Iceland
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Hwang JR, Khachemoune A. Lower lip basal cell and squamous cell carcinomas: a reappraisal of the similarities and differences in clinical presentation and management. Arch Dermatol Res 2023; 315:117-125. [PMID: 35312855 DOI: 10.1007/s00403-022-02345-z] [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: 09/09/2021] [Revised: 12/26/2021] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
Basal cell carcinoma and squamous cell carcinoma are the two most common types of carcinomas, affecting a total of 5.4 million people each year in the United States. Sun-exposed areas, especially the face and nose, are most affected given the strong association between these carcinomas and ultraviolet radiation. Less research has been done surrounding carcinomas of the lip, despite the significant aesthetic and functional importance of this area. Although lip carcinomas tend to follow a classic, unique distribution pattern that favors basal cell carcinoma on the upper lip and squamous cell carcinoma on the lower lip, more cases of lower lip basal cell carcinoma are being reported, warranting further educational awareness to differentiate carcinomas of the lower lip. In this article, we provide an updated overview of the risk factors, presentations, differential diagnoses, metastatic risks, evaluation, management guidelines, and outcomes of lower lip carcinoma. Of note, recent advances in imaging modalities are beginning to show promise as a non-invasive, affordable, and rapid way to detect and stage tumors. We conclude that increased clinical awareness and investigation of lower lip carcinoma is needed to improve early intervention, as a delayed diagnosis can rapidly alter the management and outcomes of lip carcinomas.
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Affiliation(s)
| | - Amor Khachemoune
- Veterans Affairs Medical Center, State University of New York Downstate, 800 Poly Place, Brooklyn, NY, 11209, USA. .,SUNY Downstate, Brooklyn, NY, USA.
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Moon BM, Pae WS. Reconstruction of a large lower lip defect using a combination of Abbe and staircase flaps: a case report. Arch Craniofac Surg 2022; 22:324-328. [PMID: 34974688 PMCID: PMC8721431 DOI: 10.7181/acfs.2021.00493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/18/2021] [Indexed: 11/20/2022] Open
Abstract
Lip defects often occur following wide excision as a surgical treatment for squamous cell carcinoma of the oral cavity. Defects larger than one-half of the lip cannot be closed primarily and require flap surgery. Reconstruction of the oral sphincter function can be achieved by means of a local flap using the like tissue, rather than with a free flap utilizing different tissues. A defect of the lower lip requires reconstruction using different techniques, depending on its size and location. Herein, we present the case of a patient exhibiting a lip defect spanning more than two-thirds of the lower lip, after a wide resection due to squamous cell carcinoma. The defect was reconstructed using an Abbe flap and a staircase flap. Revision was performed after 16 days. The patient’s oral competencies were fully restored 3 months postoperatively, and the esthetic results were ideal. Based on our experience, a combination of the Abbe and staircase flaps can produce excellent functional and esthetic outcomes in the reconstruction of a lower lip with a large defect. It can serve as a reliable reconstruction option for defects spanning more than two-thirds of the lower lip, not including the oral commissures.
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Affiliation(s)
- Bo Min Moon
- Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Woo Sik Pae
- Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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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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Fasting blood glucose level in oral squamous cell carcinoma: Analysis of 205 cases by histopathology and serological detection. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [DOI: 10.1016/j.adoms.2021.100070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Zhao R, Jia T, Qiao B, Liang J, Qu S, Zhu L, Feng H, Xing L, Ren Y, Wang F, Zhang H. Nomogram predicting long-term overall survival and cancer-specific survival of lip carcinoma patients based on the SEER database: A retrospective case-control study. Medicine (Baltimore) 2019; 98:e16727. [PMID: 31415366 PMCID: PMC6831112 DOI: 10.1097/md.0000000000016727] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Our study was designed to construct nomograms to predict the overall survival (OS) and cancer-specific survival (CSS) of lip carcinoma patients.A search of the Surveillance, Epidemiology, and End Results (SEER) database provided us with detailed clinical data of the 1780 lip carcinoma patients. On the basis of the credible random split-sample method, the 1780 patients were placed into 2 groups, with 890 patients in the modeling group and 890 patients in the counterpart's group (proportion = 1:1). By employing Kaplan-Meier univariate and Cox multivariate survival analyses based on the modeling cohort, the nomograms were developed and then used to divide the modeling cohort into low-risk cohort and high-risk cohort. The survival rates of the 2 groups were calculated. Internal and external evaluation of nomogram accuracy was performed by the concordance index (C-index) and calibration curves.With regard to 5- and 8-year OS and CSS, the C-indexes of internal validation were 0.762 and 0.787, whereas those of external validation reached 0.772 and 0.818, respectively. All the C-indexes were higher than 0.7. The survival curves of the low-risk cohort were obviously better than those of the high-risk cohort.Credible nomograms have been established based on the SEER large-sample population research. We believe these nomograms can contribute to the design of treatment plans and evaluations of individual prognosis.
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Affiliation(s)
- Rui Zhao
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Tingting Jia
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Bo Qiao
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Jiawu Liang
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Shuang Qu
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Liang Zhu
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Hang Feng
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Lejun Xing
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Yipeng Ren
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
| | - Fengze Wang
- Department of Stomatology, The 316th Hospital of Chinese People's Liberation Army, Xiangshan Road, Haidian District, Beijing, China
| | - Haizhong Zhang
- Oral and Maxillofacial Surgery Department, The Chinese PLA General Hospital
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Kakasheva-Mazhenkovska L, Kostovski M, Gjokik G, Janevska V. Assessment of Density of Neovascularization in Lower Lip Squamous Cell Carcinoma in Relation To Neoplasm Differentiation Grade in Patients with and without Neck Lymph Nodes Metastasis. Open Access Maced J Med Sci 2019; 7:19-23. [PMID: 30740153 PMCID: PMC6352486 DOI: 10.3889/oamjms.2019.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/17/2018] [Accepted: 12/18/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Squamous cell carcinoma (SCC) of the lower lip is a relatively rare carcinoma, with the incidence of 1 to 2%, but it is the most common carcinoma in the oral cavity accounting for 25-30% of all malignant oral tumours. AIM This study aimed to determine the role of neovascularisation in the process of tumour progression. METHODS We analysed the surgical specimens obtained from 60 patients with squamous cell carcinoma (SCC) of the lower lip. The examined group consisted of 45 specimens of patients without metastasis and 15 specimens of patients with metastasis in the regional lymph nodes. Histopathological slides were immunohistochemically stained with an antibody against CD34 and by hematoxylin & eosin staining for routine histopathological examination. RESULTS The results obtained showed a statistically significant difference in the density of neovascularisation between groups of the SCC with different grade of differentiation (Kruskal-Wallis test: H (2, N = 60) = 30.0943, p = 0.00001). Statistical analysis also showed a significant difference in the density of vascularisation of lower lip SCC between patients without metastasis and patients with neck metastasis (Mann-Whitney U test, p = 0.000198). Applying Pearson's chi-square test, we found a highly significant statistical difference in grade of SCC differentiation in patients with and without neck metastasis (p = 0.0000). CONCLUSION In conclusion, the density of neoangiogenesis is increased in tumours with poorer differentiation and in patients with neck metastasis. So, the density of neovascularisation of the primary lip SCC may predict the tumour progression.
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Affiliation(s)
- Lena Kakasheva-Mazhenkovska
- Institute of Histology and Embryology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Marko Kostovski
- Institute of Histology and Embryology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Gjorgje Gjokik
- University Clinic for Plastic and Reconstructive Surgery, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Vesna Janevska
- Institute of Pathology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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