Management of recurrent lower lip carcinomas

Yıl 2010, Cilt: 20 Sayı: 5, 237 - 242, 15.10.2010

Ömer Genç Hasan Mete İnançlı Şefik Sinan Kürkçüoğlu Ümit Tunçel Murat Enöz Mehmet Haksever

Öz

Objectives: In this study patients who had locoregional recurrence of lower lip carcinomas after therapies such as surgery, electrocoagulation, cryotherapy or traditional local therapies are discussed. Patients and Methods: The records of 16 cases 1 female, 15 males; mean age 58 years; range 30 to 83 years with recurrent lower lip carcinoma admitted between March 2002 and September 2007 to Dr. Abdurrahman Yurtarslan Oncology Training and Research Hospital, Ear, Nose and Throat Department were retrospectively reviewed. Results: Fourteen patients had been treated in other institutions, while two had been treated in our center. Four of the patients had recurrence in the lip, four patients had recurrence only in the neck, and the remaining eight patients had both lip and neck recurrence. Ten patients received modified radical or radical neck dissection because of their palpable lymphadenopathies, three patients received supraomohyoid neck dissection due to non palpable lymphadenopathies, and the remaining three patients did not have neck dissection because of co-morbid diseases. Seven patients 43% died in the first postoperative year because of lower lip carcinomas and three patients died because of other reasons. Six patients survived for the first two years without any evidence of disease. Conclusion: Patient survival will be affected by the applied treatment. For patients with primary lower lip cancers, otolaryngologists experienced in oncology must plan surgery rather than local treatments. In case of locoregional recurrence, immediate treatment should be planned.

Anahtar Kelimeler

Lip cancers, resection of periosteum, squamous cell carcinoma, treatment

Nüks alt dudak kanserlerine yaklaşım

Öz

Amaç: Bu çalışmada alt dudak kanseri tanısı ile cerrahi, elektrokoagülasyon, kriyoterapi ya da geleneksel lokal tedaviler sonrası lokorejyonel nüks gelişen hastalara uygulanacak tedavi prensipleri tartışıldı.Hastalar ve Yöntemler: Dr. Abdurrahman Yurtarslan Onkoloji Eğitim ve Araştırma Hastanesi Kulak Burun Boğaz Kliniği’nde, Mart 2002 - Eylül 2007 tarihleri arasında, alt dudak kanseri tedavisi gören ancak takibinde nüks gelişen 16 hastanın 1 kadın, 15 erkek; ort. yaş 58 yıl; dağılım 30-83 yıl kayıtları geriye dönük olarak literatür eşliğinde incelendi.Bulgular: İki hasta kendi merkezimizde tedavi alırken, 14’ü dış merkezlerde, birincil tedavi almıştı. Hastalardan dördünde nüks dudakta, dördünde sadece boynunda, kalan sekizinde ise hem dudak hem de boynunda idi. On hastaya ele gelen lenfadenopati nedeniyle radikal veya modifiye radikal boyun diseksiyonu, üç hastaya da ele gelmeyen lenfadenopati nedeniyle supraomohiyoid boyun diseksiyonu yapıldı, geriye kalan üç N0 boyunlu hastaya ise nüks alt dudak kanseri tanısını takiben eşlik eden ek hastalık nedeniyle boyun diseksiyonu yapılamadı. Ameliyat sonrası birinci yılda yedi hasta %43 alt dudak kanseri nedeniyle ve üç hasta diğer nedenlerden kaybedildi. Altı hasta ilk iki yıl hastalıksız yaşadı.Sonuç: Uygulanacak tedavi hastanın sağkalımını önemli ölçüde etkileyecektir. Birincil alt dudak tümörlü hastalar başvurduğunda lokal tedaviler yerine, onkoloji deneyimi olan KBB hekimlerince cerrahi tedavi planlanmalıdır. Lokorejyonel nüks durumunda ise zaman kaybedilmeden cerrahi tedavi planlanmalıdır

Anahtar Kelimeler

Dudak kanseri, periost rezeksiyonu, yassı epitel hücreli karsinom, tedavi

Kaynakça

• Wurman LH, Adams GL, Meyerhoff WL. Carcinoma of the lip. Am J Surg 1975;130:470-4.
• Zitsch RP 3rd. Carcinoma of the lip. Otolaryngol Clin North Am 1993;26:265-77.
• Renner GJ, Zitsch RP III. Cancer of the lip. In: Myers EN, Suen JY, editors. Cancer of the head and neck. 3rd ed. Philadelphia: W. B. Saunders; 1996. p. 294-320.
• Jorgensen K, Elbrond O, Andersen AP. Carcinoma of the lip. A series of 869 cases. Acta Radiol Ther Phys Biol 1973;12:177-90.
• Hendricks JL, Mendelson BC, Woods JE. Invasive carcinoma of the lower lip. Surg Clin North Am 1977; 57:837-44.
• Luce EA. Reconstruction of the lower lip. Clin Plast Surg 1995;22:109-21.
• Baker SR, Krause CJ. Carcinoma of the lip. Laryngoscope 1980;90:19-27.
• Jesse RH. Extensive cancer of the lip. Surgical therapy. Arch Surg 1967;94:509-16.
• Unsal-Tuna E, Oksüzler O, Ozbek C, Ozdem C. Surgical management of lower lip cancers. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2008;18:148-52.
• Minovi A, Hertel A, Ural A, Hofmann E, Draf W, Bockmuehl U. Is PET superior to MRI in the prethera- peutic evaluation of head and neck squamous cell car- cinoma? [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2007;17:324-8.
• Onerci M, Yilmaz T, Gedikoğlu G. Tumor thickness as a predictor of cervical lymph node metastasis in squamous cell carcinoma of the lower lip. Otolaryngol Head Neck Surg 2000;122:139-42.
• Altinyollar H, Bulut H, Berberoglu U. Is suprahyoid dissection a diagnostic operation in lower lip carci- noma? J Exp Clin Cancer Res 2002;21:29-30.
• Cruse CW, Radocha RF. Squamous cell carcinoma of the lip. Plast Reconstr Surg 1987;80:787-91.
• Lindelİv B, Kirkegaard J, Hansen HS. Squamous cell carcinoma of the oral cavity. An unselected material from a 5-year period. Acta Oncol 1990;29:1011-5.
• Uğurluer G, Ozyurt SC, Aksaray F, Aslan N, Habiboğlu R, Tümöz M. Prognostic factors and survival rates in oral cavity cancers. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2006;16:64-71.
• de Visscher JG, Botke G, Schakenraad JA, van der Waal I. A comparison of results after radiotherapy and sur- gery for stage I squamous cell carcinoma of the lower lip. Head Neck 1999;21:526-30.
• Guney E, Yigitbasi OG. Functional surgical approach to the level I for staging early carcinoma of the lower lip. Otolaryngol Head Neck Surg 2004;131:503-8.
• de Visscher JG, van den Elsaker K, Grond AJ, van der Wal JE, van der Waal I. Surgical treatment of squa- mous cell carcinoma of the lower lip: evaluation of long-term results and prognostic factors-a retrospec- tive analysis of 184 patients. J Oral Maxillofac Surg 1998;56:814-20.
• Kutluhan A, Kiriş M, Kaya Z, Kisli E, Yurttaş V, Içli M, et al. Squamous cell carcinoma of the lower lip and supra-omohyoid neck dissection. Acta Chir Belg 2003; 103:304-8.
• Brown RG, Poole MD, Calamel PM, Bakamjian VY. Advanced and recurrent squamous carcinoma of the lower lip. Am J Surg 1976;132:492-7.
• Creely JJ Jr, Peterson HD. Carcinoma of the lip. South Med J 1974;67:779-84.
• Brown JS, Kalavrezos N, D’Souza J, Lowe D, Magennis P, Woolgar JA. Factors that influence the method of mandibular resection in the management of oral squa- mous cell carcinoma. Br J Oral Maxillofac Surg 2002; 40:275-84.
• Zitsch RP 3rd. Carcinoma of the lip. Otolaryngol Clin North Am 1993;26:265-77.
• Villaret AB, Cappiello J, Piazza C, Pedruzzi B, Nicolai P. Quality of life in patients treated for cancer of the oral cavity requiring reconstruction: a prospective study. Acta Otorhinolaryngol Ital 2008;28:120-5.
• Kocatürk S, Ozdemir N, Erkam U, Uzun H, Babila A, Oztürk E. Evaluation of occult lymph node metastasis in lower lip cancers and approach to N(0) neck metas- tasis. [Article in Turkish] Kulak Burun Bogaz Ihtis Derg 2002;9:41-5.