Clinical Oral Investigations

, Volume 19, Issue 5, pp 1093–1099 | Cite as

Long-term outcome and subjective quality of life after surgical treatment of lower lip cancer

  • Michael Schüller
  • Martin Gosau
  • Steffen Müller
  • Michael Gerken
  • Christian Rohrmeier
  • Stefan Legal
  • Stephan Schreml
  • Tobias Ettl
Original Article

Abstract

Objectives

Squamous cell carcinoma of the lower lip represents a common type of cancer with a favourable prognosis. Different types of defect reconstruction after ablative surgery are described for maintenance of patients’ quality of life.

Materials and methods

The study retrospectively evaluates the outcome of 105 patients treated for lower lip cancer. Oncological data as well as individual quality of life were investigated.

Results

Cervical lymph node metastases rarely occurred (7.6 %) and were correlated to larger-sized tumours (p = 0.041). Only five patients (4.8) died related to the tumour disease, especially after lymph node metastasis and tumour recurrence (p < 0.001). The 5-year rates for recurrence-free, overall and disease-specific survival were 84.5, 61.2 and 93.9 %. Tumour recurrence correlated with a resection margin of less than 0.75 cm (p = 0.089). With view to postoperative quality of life, the modified Bernard-Fries technique showed the most unfavourable results, particularly referring to sensibility, paraesthesia, lip pursing and mouth opening compared to a stair-step and/or Abbe reconstructions.

Conclusions

Squamous cell carcinoma of the lower lip shows a very favourable prognosis. Neck dissection seems often negligible particularly in small tumours. Patients’ functional quality of life after lip surgery depends on the size of the primary and the used technique. Stair-step and/or Abbe reconstructions should be preferred to a Bernard-Fries technique in comparable defect sizes.

Clinical relevance

Proper treatment of lower lip cancer provides favourable prognosis and preserves patients’ functional and aesthetic quality of life.

Keywords

Lip cancer Resection margin Lymph node metastasis Reconstruction technique Quality of life 

References

  1. 1.
    Zitsch RP 3rd, Park CW, Renner GJ, Rea JL (1995) Outcome analysis for lip carcinoma. Otolaryngol-Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg 113:589–596CrossRefGoogle Scholar
  2. 2.
    Baker SR, Krause CJ (1980) Carcinoma of the lip. Laryngoscope 90:19–27CrossRefPubMedGoogle Scholar
  3. 3.
    Bucur A, Stefanescu L (2004) Management of patients with squamous cell carcinoma of the lower lip and N0-neck. J Cranio-Maxillofac Surg 32:16–18CrossRefGoogle Scholar
  4. 4.
    Shah J, Patel S, Singh B (2012) Lips. In: Jatin Shah’s head and neck surgery and oncology (Fourth Edition.). MosbyGoogle Scholar
  5. 5.
    Webster RC, Coffey RJ, Kelleher RE (1960) Total and partial reconstruction of the lower lip with innervated musclebearing flaps. Plast Reconstr Surg Transpl Bull 25:360–371CrossRefGoogle Scholar
  6. 6.
    Fries R (1973) Advantages of a basic concept in lip reconstruction after tumour resection. J Maxillofac Surg 1:13–18CrossRefPubMedGoogle Scholar
  7. 7.
    Roldán JC, Teschke M, Fritzer E et al (2007) Reconstruction of the lower lip: rationale to preserve the aesthetic units of the face. Plast Reconstr Surg 120:1231–1239CrossRefPubMedGoogle Scholar
  8. 8.
    Greene FL, Sobin LH (2009) A worldwide approach to the TNM staging system: collaborative efforts of the AJCC and UICC. J Surg Oncol 99:269–272CrossRefPubMedGoogle Scholar
  9. 9.
    Vartanian JG, Carvalho AL, de Araújo Filho MJ et al (2004) Predictive factors and distribution of lymph node metastasis in lip cancer patients and their implications on the treatment of the neck. Oral Oncol 40:223–227CrossRefPubMedGoogle Scholar
  10. 10.
    De Visscher JG, van den Elsaker K, Grond AJ et al (1998) 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 Off J Am Assoc Oral Maxillofac Surg 56:814–820, discussion 820–821CrossRefGoogle Scholar
  11. 11.
    Najim M, Cross S, Gebski V et al (2013) Early-stage squamous cell carcinoma of the lip: the Australian experience and the benefits of radiotherapy in improving outcome in high-risk patients after resection. Head Neck 35:1426–1430PubMedGoogle Scholar
  12. 12.
    De Visscher JGAM, Gooris PJJ, Vermey A, Roodenburg JLN (2002) Surgical margins for resection of squamous cell carcinoma of the lower lip. Int J Oral Maxillofac Surg 31:154–157CrossRefPubMedGoogle Scholar
  13. 13.
    Zitsch RP 3rd, Lee BW, Smith RB (1999) Cervical lymph node metastases and squamous cell carcinoma of the lip. Head Neck 21:447–453CrossRefPubMedGoogle Scholar
  14. 14.
    de M Vanderlei JP, Pereira-Filho FJF, da Cruz FA et al (2013) Management of neck metastases in T2N0 lip squamous cell carcinoma. Am J Otolaryngol 34:103–106CrossRefPubMedGoogle Scholar
  15. 15.
    Jorgensen K, Elbrond O, Andersen AP (1973) Carcinoma of the lip. A series of 869 patients. Acta Otolaryngol (Stockh) 75:312–313CrossRefGoogle Scholar
  16. 16.
    Harris L, Higgins K, Enepekides D (2012) Local flap reconstruction of acquired lip defects. Curr Opin Otolaryngol Head Neck Surg 20:254–261CrossRefPubMedGoogle Scholar
  17. 17.
    Salgarelli AC, Bellini P, Magnoni C et al (2011) Synergistic use of local flaps for total lower lip reconstruction. Dermatol Surg Off Publ Am Soc Dermatol Surg Al 37:1666–1670Google Scholar
  18. 18.
    Baumann D, Robb G (2008) Lip reconstruction. Semin Plast Surg 22:269–280CrossRefPubMedCentralPubMedGoogle Scholar
  19. 19.
    De Palma AT, Leavitt LA, Hardy SB (1958) Electromyography in full thickness flaps rotated between upper and lower lips. Plast Reconstr Surg Transplant Bull 21:448–452Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Michael Schüller
    • 1
  • Martin Gosau
    • 1
  • Steffen Müller
    • 1
  • Michael Gerken
    • 4
  • Christian Rohrmeier
    • 2
  • Stefan Legal
    • 1
  • Stephan Schreml
    • 3
  • Tobias Ettl
    • 1
  1. 1.Department of Oral and Maxillofacial SurgeryUniversity Hospital of RegensburgRegensburgGermany
  2. 2.Department of OtorhinolaryngologyUniversity Hospital of RegensburgRegensburgGermany
  3. 3.Department of DermatologyUniversity Hospital of RegensburgRegensburgGermany
  4. 4.Center of Tumor RegistryUniversity of RegensburgRegensburgGermany

Personalised recommendations