Objectives: In this study, we analyzed the surgical approach
which we carried out for treatment of the primary mass and neck
in 24 lower lip cancer cases and its results.
Patients and Methods: 24 patients (5 females, 19 males; mean
age 56.8; range 41 to 72 years) who were operated on in our
clinic for lip cancer between March 1995 and March 2007 and
whom we were able to long term follow-up were included in this
study. Tumor was resected with 1-2 cm surgical margin in all
cases. The tissue defect was reconstructed by either primary
closure or local/regional flaps. If the tumor was located in the
middle of the lip, bilateral neck dissection, otherwise unilateral
neck dissection was performed. Postoperative radiotherapy was
used in cases who had neck metastatic disease. Functional
results were evaluated regarding recurrence and mortality rates
during five-year mean follow-up period.
Results: Tumor was originated from the lower lip alone in 20 cases.
There was secondary commissure involvement in four cases.
According to the TNM (tumor, node, metastasis) classification
(AJCC, 2002), distribution of the cases was T1N0M0 (n=10), T2N0M0
(n=9), T3N1M0 (n=3), T4N2aM0 (n=1), T4N2cM0 (n=1). Primary closure
(n=7), Abbe-Estlander flap (n=9), Karapandzic flap (n=4), Melolabial
flap (n=3), Fan flap (n=1), pectoralis major myocutaneous flap (n=2)
were used as reconstruction techniques. Histopatologically, metastatic
disease was determined in the neck in four cases. During the
follow-up period, there occurred ocal recurrence in two cases and
regional metastasis in one. Two cases with distant metastasis died.
Survival rates without illness for early and advanced stage tumors
were 100% and 20%, respectively. Functional results after reconstruction
were satisfactory, except in two cases which we used
pectoralis major myocutaneous flap for reconstruction.
Conclusion: Five-years survival rates without illness were significantly
lower in cases with advanced stage tumor and N positive
neck. This result indicates that stage of the tumor and neck involvement
have a significant effect on prognosis. Furthermore, more satisfactory
functional results were achieved in early stage tumors.
FREE FULL TEXTAnahtar Kelimeler: Dudak kanseri; rekonstrüksiyon; cerrahi