R P Zitsch1, B W Lee, R B Smith. 1. University Hospital and Clinics, and Ellis Fischel Cancer Center, Division of Otolaryngology, Department of Surgery, University of Missouri-Columbia School of Medicine, Columbia, Missouri, USA. zitschr@health.missouri.edu
Abstract
BACKGROUND: Squamous cell carcinoma of the lip generally has a favorable outcome. The chance of long-term survival is significantly reduced if lymph node metastases develop. Any features that could identify patients having increased risks of occult lymph node metastases would allow more aggressive treatment and, possibly, a better outcome. METHODS: A chart review of lip cancer from this institution identified 1001 patients with squamous cell carcinoma of the lip. This database was used to identify the characteristics that are associated with occult lymph node metastases. RESULTS: Delayed cervical lymph node metastases developed in 40 patients. No significant differences were noted in the frequency of delayed lymph node metastases according to gender, lip subsite, or age less than 40 years. Significant differences were noted in association with the tumor size, tumor differentiation, and local recurrence. CONCLUSIONS: Elective cervical lymphadenectomy is justifiable for higher grade tumors and for locally recurrent tumors. An increase in delayed metastases was observed in patients with tumors greater than 3 cm, but the proportion is not great enough to justify elective neck dissections. Copyright 1999 John Wiley & Sons, Inc. Head Neck 21: 447-453, 1999.
BACKGROUND:Squamous cell carcinoma of the lip generally has a favorable outcome. The chance of long-term survival is significantly reduced if lymph node metastases develop. Any features that could identify patients having increased risks of occult lymph node metastases would allow more aggressive treatment and, possibly, a better outcome. METHODS: A chart review of lip cancer from this institution identified 1001 patients with squamous cell carcinoma of the lip. This database was used to identify the characteristics that are associated with occult lymph node metastases. RESULTS: Delayed cervical lymph node metastases developed in 40 patients. No significant differences were noted in the frequency of delayed lymph node metastases according to gender, lip subsite, or age less than 40 years. Significant differences were noted in association with the tumor size, tumor differentiation, and local recurrence. CONCLUSIONS: Elective cervical lymphadenectomy is justifiable for higher grade tumors and for locally recurrent tumors. An increase in delayed metastases was observed in patients with tumors greater than 3 cm, but the proportion is not great enough to justify elective neck dissections. Copyright 1999 John Wiley & Sons, Inc. Head Neck 21: 447-453, 1999.
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