Treatment of Squamous Cell Carcinoma of the Lower Lip with a Defect Involving Up to 1/3 of Lip Length
Clinical scenario
This protocol covers squamous cell carcinoma of the lower lip presenting as a T1 lesion — less than 2 cm in size — where resection results in a tissue defect involving up to one-third of the lip length.
Specific condition
The diagnosis is squamous cell carcinoma of the lip, confirmed histologically. The T1 stage and the extent of the resulting lip defect (≤1/3 of lip length) directly govern the selection of the surgical approach and the method of reconstruction.
More than half of patients in the evidence base presenting with this disease fall within the T1 category (lesions less than 2 cm, defect less than 1/3 of lip length).
Treatment approach — partial overview
Surgical removal is the treatment of choice. The approach involves full-thickness radical excision of the tumor, with the reconstruction technique selected according to the size and location of the resulting defect. For suitable small lesions, a non-surgical local modality may serve as an alternative.
Treatment goal: clear (healthy) surgical resection margins with no local tumor recurrence.
References
DOI: 10.1016/j.maxilo.2015.03.006
- Of all patients, 89 (56.3%) had T1 (lesions less than 2 cm long, less than 1/3).
- Surgical removal is the treatment of choice for squamous cell carcinoma of the lower lip, although radiotherapy or brachytherapy can be used to treat small lesions; tissue loss is treated using a variety of techniques, depending on the extent and location (median or lateral) of the defect.
- 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).
- The prognosis improves if the margins are healthy and the resection radical.
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