This protocol covers a defined surgical scenario: a squamous cell carcinoma of the lower lip classified as T2 (lesion ≥ 2 cm) that produces a tissue defect of up to two-thirds of the lip length, with the oral commissure remaining uninvolved.
Squamous cell carcinoma of the lower lip at T2 stage (≥ 2 cm) with a defect extent up to 2/3 of the total lip length. The commissure is not involved, which defines both the extent of resection required and the available reconstructive approaches.
Management centres on full-thickness radical excision of the lower lip tumour with precise attention to resection margin clearance, followed by reconstructive flap repair selected according to the size and position of the resulting defect. Post-operative pharmacological support is also part of the protocol. The complete margin criteria, flap selection algorithm, and supportive regimen are available in the full protocol.
Healthy (clear) surgical resection margins and absence of local tumour recurrence.
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).
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).
We decided to correct 91 defects involving up to 60% of the lower lip using staircase or wave flaps.
The prognosis improves if the margins are healthy and the resection radical.
In our present study, we report no disease recurrences.
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