OUTCOME ANALYSIS FOR LIP CARCINOMA

Carcinoma of the lip is a relatively common malignancy of the head and neck region, accounting for approximately one quarter of oral cavity cancers. Although this form of cancer is generally readily curable com pared with malignancies at other head and neck sites, regional metasta ses, local recurrence, and even death from this disease may occasional ly occur. A review of 1252 patients who were diagnosed with lip cancer from 1940 to 1987 was undertaken to identity and rank prognostic vari ables, clarify differential incidences of site predilection between ma le and female patients, and examine the correlation between tumor site and histopathologic diagnoses, Large tumor size, high tumor-grade, th e presence of adenopathy, a subsite other than the lower lip, and inad equate surgical margins were found to have a negative impact on determ inate survival of patients with lip carcinoma. Twenty-one percent of l ip cancers in female patients arose on the upper lip, whereas only 3% of rip cancers in male patients developed on the upper rip, Basal cell carcinomas comprised 13% of upper lip cancers and only less than 1% o f lower lip cancers. Recurrence developed in 15.1% of the patients rev iewed and was strongly associated with large tumor size and poor diffe rentiation. Local recurrence was associated with a determinate surviva l of 78%, whereas patients having regional recurrences had a survival rate of 52%. These data support aggressive treatment of lip cancers gr eater than 3 cm in diameter, high-grade tumors, tumors associated with cervical lymphadenopathy, and upper lip and commissure tumors. tip ca ncer in women seems to be slightly more aggressive than in men.