Treatment of Squamous Cell Carcinoma of the Lower Lip When the Defect Involves More Than Two-Thirds of the Lip Length
Clinical Scenario
This protocol addresses squamous cell carcinoma of the lower lip in patients where the tumor or its excision results in a defect spanning more than 2/3 (60–100%) of the total lip length T3 · ≥4 cm. These extensive lesions require coordinated oncological excision and a planned reconstructive approach.
Treatment Approach (Partial Overview)
Management centers on full-thickness radical excision of the lower lip tumor under general anesthesia, followed by lip reconstruction using regional flap techniques — the specific flap strategy is selected according to the extent of tissue loss and is detailed in the full protocol.
Treatment Goals
Achieving healthy (clear) surgical resection margins and the absence of local tumor recurrence.
References
DOI: 10.1016/j.maxilo.2015.03.006
- The remaining patients had T2 lesions ≥2 cm, up to 2/3 of lip involvement (50 patients), T3 lesions ≥ 4 cm, more than 2/3 of lip involvement (18), and a T4 lesion ≥5.5 cm with commissure involvement (1).
- The Bernard–Freeman–Fries technique is performed under general anesthesia with nasotracheal intubation.
- It was imperative that each lesion be radically excised, leaving an adequate safety margin on all sides (always 6–10 mm if margins were not examined by a pathologist working in the operating theater, and 3 mm otherwise).
- When a defect involved 60–100% of the lower lip, a Bernard–Freeman–Fries flap was the favored solution and was constructed for 5.7% of patients.
- If over 2/3 of the lower lip is lost (over 60%), a combination of a Sabattini–Abbé flap and a bilateral staircase flap should be considered.
- The prognosis improves if the margins are healthy and the resection radical.
- In our present study, we report no disease recurrences.
View source ↗