Abstract
OBJECTIVES: The aim of this study is to investigate
the role of neck dissection and wait-see policy for neck treatment on prognosis
of patients with early stage lip cancer.
METHODS: The study included 20 patients ( 5 females,
15 males; mean age 62.64 years; range 38 to 80 years) who
underwent surgery for primary site and neck between March 2007 and April
2015 because of T1-2N0 lower lip cancer. Data were reviewed retrospectively on
clinical features, localization of the lesion, regional lymph node status,
tumor staging, results of surgical treatment and pathological examination.
Tumor was excised with 1 cm surgical margin in all cases. The tissue defect was
reconstructed by primary closure or varied reconstrction techniqcs. All T2N0
stage patients underwent neck dissection. If the tumor was located in the
middle of the lip, bilateral neck dissection, otherwise unilateral neck
dissection was performed.
RESULTS: Histopathologic diagnosis was squamous cell
carcinoma in all cases. The mean follow-up period was 45.82 months. There
were 15 patients with clinically diagnosed T1N0 tumors and 5 patients with
clinically diagnosed T2N0 tumors. For T1N0 tumors, 3 suprahyoid, 2 bilateral
supraomohyoid neck dissections were performed. Supraomohyoid neck dissection
was performed in bilaterally in 3 T2N0 tumors, and suprahyoid neck dissection
was performed in remaing 2 tumors.
CONCLUSION: Four years survival rates without illness
were significantly higher in cases with early stage lip cancer. Our results
present that neck dissection may not be necessary in patients with T1N0 lower
lip cancers.
References
- Morselli P, Masciotra L, Pinto V, Zollino I, Brunelli G, Carinci F. Clinical parameters in T1N0M0 lower lip squamous cell carcinoma. J Craniofac Surg. 2007; 18(5):1079-1082.
- Baker SR. Risk factors in multiple carcinomas of the lip. Otolaryngol Head Neck Surg (1979). 1980;88(3):248-251.
- de Visscher JG, van den Elsaker K, Grond AJ, van der Wal JE, van der Waal I. Surgical treatment of squamous cell carcinoma of the lower lip: evaluation of long-term results and prognostic factors--a retrospective analysis of 184 patients. J Oral Maxillofac Surg. 1998;56(7):814-820.
- Onercl M(1), Yilmaz T, Gedikoğlu G. Tumor thickness as a predictor of cervical lymph node metastases in squamous cell carcinoma of the lower lip. Otolaryngol Head Neck Surg. 2000 ;122(1):139-142.
- Baker SR, Krause CJ. Carcinoma of the lip. Laryngoscope. 1980;90(1):19-27.
- Guney E, Yigitbasi OG. Functional surgical approach to the level I for staging early carcinoma of the lower lip. Otolaryngol Head Neck Surg. 2004;131(4):503-508.
- Vanderlei JP, Pereira-Filho FJ, da Cruz FA, de Mello FL, Kruschewsky Lde S, de Freitas LC, at al. Management of neck metastases in T2N0 lip squamouz cell carcinoma. Am J Otolaryngol. 2013;34(2):103-106.
- Bucur A, Stefanescu L. Management of patients with squamous cell carcinoma of the lower lip and N0-neck. J Craniomaxillofac Surg. 2004;32(1):16-18.
Abstract
AMAÇ Bu çalışmanın
amacı, erken evre dudak kanseri hastalarında, bekle-gör politikasının ve boyun
diseksiyonunun prognoz üzerindeki rolünü araştırmaktır.
GEREÇ - YÖNTEMLER:
Mart 2007 - Nisan 2015 yılları arasında T1-2N0 alt dudak kanseri nedeniyle primer
bölge ve boyun cerrahisi yapılan 20
hasta (5 kadın, 15 erkek; yaş ortalaması 62.64 yıl; 38-80 yaş aralığı)
çalışmaya dahil edildi. Klinik özellikler, lezyonun lokalizasyonu, bölgesel
lenf nodu durumu, tümör evrelemesi, cerrahi tedavi sonuçları ve patolojik
inceleme verileri geriye dönük olarak incelendi. Tüm olgularda 1 cm cerrahi
sınırla tümör eksize edildi. Doku defekti birincil kapatma ya da çeşitli rekonstriksiyon
teknikleri ile onarıldı. Tüm T2N0 evre hastalara boyun diseksiyonu uygulandı.
Tümör dudağın ortasında yer alıyorsa, bilateral boyun diseksiyonu, aksi
taktirde tek taraflı boyun diseksiyonu yapıldı.
BULGULAR: Her olguda histopatolojik tanı
skuamöz hücreli karsinomdu. Ortalama izlem süresi 45.82 ay idi. Klinik olarak
T1N0 tümörü tanısı konan 15 hasta ve klinik olarak T2N0 tümörü tanısı konan 5
hasta vardı. T1N0 tümörleri için 3 suprahyoid, 2 bilateral supraomohyoid boyun
diseksiyonu yapıldı. Üç T2N0 tümöründe supraomohyoid boyun disseksiyonu
bilateral olarak yapıldı ve geriye kalan 2 hastada suprahyoid boyun diseksiyonu
yapıldı.
SONUÇ: Hastalıksız
dört yıllık sağ kalım oranları, erken evre dudak kanseri vakalarında belirgin
olarak daha yüksekti. Sonuçlarımız T1N0 alt dudak kanserlerinde boyun
diseksiyonunun gerekli olmayabileceğini göstermektedir.
References
- Morselli P, Masciotra L, Pinto V, Zollino I, Brunelli G, Carinci F. Clinical parameters in T1N0M0 lower lip squamous cell carcinoma. J Craniofac Surg. 2007; 18(5):1079-1082.
- Baker SR. Risk factors in multiple carcinomas of the lip. Otolaryngol Head Neck Surg (1979). 1980;88(3):248-251.
- de Visscher JG, van den Elsaker K, Grond AJ, van der Wal JE, van der Waal I. Surgical treatment of squamous cell carcinoma of the lower lip: evaluation of long-term results and prognostic factors--a retrospective analysis of 184 patients. J Oral Maxillofac Surg. 1998;56(7):814-820.
- Onercl M(1), Yilmaz T, Gedikoğlu G. Tumor thickness as a predictor of cervical lymph node metastases in squamous cell carcinoma of the lower lip. Otolaryngol Head Neck Surg. 2000 ;122(1):139-142.
- Baker SR, Krause CJ. Carcinoma of the lip. Laryngoscope. 1980;90(1):19-27.
- Guney E, Yigitbasi OG. Functional surgical approach to the level I for staging early carcinoma of the lower lip. Otolaryngol Head Neck Surg. 2004;131(4):503-508.
- Vanderlei JP, Pereira-Filho FJ, da Cruz FA, de Mello FL, Kruschewsky Lde S, de Freitas LC, at al. Management of neck metastases in T2N0 lip squamouz cell carcinoma. Am J Otolaryngol. 2013;34(2):103-106.
- Bucur A, Stefanescu L. Management of patients with squamous cell carcinoma of the lower lip and N0-neck. J Craniomaxillofac Surg. 2004;32(1):16-18.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | January 4, 2018 |
| Submission Date | December 2, 2017 |
| Published in Issue | Year 2017 Volume: 7 Issue: 4 |
The published articles in SMJ are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.