Pathology
Lip Cancer: A Clinicopathological Study and Treatment Outcomes in a 25-Year Experience

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Purpose

There are few clinical studies focusing on treatment outcomes of lip cancer. This study investigated the clinicopathologic variables of a large sample of patients with lip squamous cell carcinoma (LSCC) treated in a reference head and neck cancer center for the past 25 years and analyzed the influence of these variables on treatment outcomes.

Materials and Methods

This retrospective cohort study reviewed the clinical records of patients with LSCC. Epidemiologic data were age, gender, ethnicity, type of occupation, tobacco smoking, alcohol consumption, comorbid conditions, and family cancer history. Clinicopathologic features included the lip location of the tumor, TNM classification, clinical staging, histopathologic grade, surgical margin analysis, and treatment modality. Local recurrence, second primary tumor, and survival were the outcome variables. Statistical analysis was performed by χ2 test, Fisher exact test, and binary logistic regression analysis. Survival analysis was assessed through the Kaplan-Meier curve. Level of statistical significance was set at a P value less than .05 for all tests.

Results

In total, 144 patients with LSCC were studied. There were 117 men (81.25%) and 27 women (18.75%) with a mean age of 60.21 years. One hundred thirty-four patients (93.05%) were considered of white ethnicity, and in 57 cases (39.58%), the patients reported an occupation that was related to long-term solar exposure. Most cancers had initial clinical staging of 1 or 2 (84.02%). Microscopically, lesions were predominantly well (43.05%) and moderately (40.96%) differentiated tumors. Clinical staging was related to a specific higher survival rate (P = .0049). One hundred twelve cases (77.78%) underwent surgical treatment and only 6 patients (4.80%) had local recurrence, which was directly associated with compromised surgical margins (P = .0320).

Conclusion

A high success rate in LSCC treatment was observed in this study. Compromised surgical margin was associated with tumor recurrence and is a critical event in lip cancer treatment.

Section snippets

Study Design and Sample

To address the research purpose, the authors designed and implemented a retrospective cohort study (approved by the human studies committee, protocol number 2011-01314). This study followed the guidelines of the Declaration of Helsinki. The study population was comprised of all patients presenting for evaluation and treatment of LSCC from January 1989 through December 2013 at the Oral Oncology Center, Araçatuba Dental School, São Paulo State University (UNESP), Brazil.

Patients were included in

Epidemiologic Features

Clinical reports of 144 patients with LSCC were studied. There were 117 men (81.25%) and 27 women (18.75%) whose age ranged from 19 to 98 years (mean, 60.21 yr). The age intervals of younger than 53 years (32.00%), 53 to 65 years (29.80%), 66 to 75 years (17.36%), and older than 75 years (20.84%) were considered for this study, according to age range lip cancer criteria defined by Czerninski et al.5 Analysis of gender with age range showed no statistical differences (P = .0967). One hundred

Discussion

The purpose of this study was to investigate the clinicopathologic profile and treatment outcomes of patients with LSCC treated in a single institution for the past 25 years. Based on the literature and the authors' clinical experience, the study's main hypothesis predicted that clinicopathologic variables would affect treatment outcomes in patients with LSCC. In this retrospective cohort study, most patients with LSCC were men (81.25%), had white ethnicity (93.05%), had the tumor located in

References (28)

  • G.J. McGregor et al.

    Impact of cervical lymph node metastases from squamous cell cancer of the lip

    Am J Surg

    (1992)
  • International Statistical Classification of Diseases, Injuries and Causes of Death (Rev 9)

    (1975)
  • S.R. Moore et al.

    The epidemiology of lip cancer: A review of global incidence and aetiology

    Oral Dis

    (1999)
  • R. Czerninski et al.

    Lip cancer: incidence, trends, histology and survival: 1970-2006

    Br J Dermatol

    (2010)
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    Conflict of Interest Disclosures: None of the authors have any relevant financial relationship(s) with a commercial interest.

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