SURGICAL-TREATMENT OF SQUAMOUS-CELL CARCINOMA OF THE LOWER LIP - EVALUATION OF LONG-TERM RESULTS AND PROGNOSTIC FACTORS - A RETROSPECTIVE ANALYSIS OF 184 PATIENTS

Purpose: A retrospective study was undertaken to evaluate the results of surgical treatment of primary squamous cell carcinoma of the vermil ion border of the lower lip and to identify parameters of the primary tumor that may predict local recurrence and regional metastasis. Patie nts and Methods: From 1979 through 1992, 184 consecutive patients with a primary squamous cell carcinoma of the lower lip underwent surgical excision as a primary treatment. There were 166 (90.2%) men and 18 (9 .8%) women, with a mean age of 66 years. Most cases (92.9%) were stage I tumors. Most of the tumors were well and moderately differentiated squamous cell carcinomas (93.50%). Minimal follow-up was 2 years, with a mean of 56 months. Disease control was achieved in 165 (87.9%) pati ents. Local recurrence and regional metastasis occurred in 9 (4.9%) an d 10 (5.4%) patients, respectively. Local failures were treated succes sfully by either surgery or radiation therapy. Regional metastases wer e treated in nine patients by neck dissection, followed in eight cases by radiation therapy. One patient developed distant metastasis. Resul ts: Five- and 10-year overall survival rates were 78% and 61%, respect ively, whereas the disease-free survival rates at 5 and 10 years were 86% and 81%, respectively. Multivariate analysis indicated that local recurrence was significantly associated with large tumor size and surg ical margins containing squamous cell carcinoma. Increasing tumor thic kness, an infiltrative invasion pattern, and perineural invasion were significant prognostic indicators of regional metastasis. Conclusion: Surgical treatment for small squamous cell carcinomas of the lower lip has a favorable prognosis. Particular parameters of the primary tumor seem to predict the chance of development of local recurrence and reg ional lymph node metastasis.