Neck Dissection in Early-stage Squamous Cell Carcinoma of the Lower Lip: Mid-term Treatment Results

Aim: To evaluate the mid-term treatment results in early-stage squamous cell carcinoma (SCC) of the lower lip and to investigate the effect of tumor depth and size on neck metastasis. Methods: The study included 52 patients who were operated between 2010 and 2017 for early-stage primary SSC of the lip with negative surgical margins and without oral commissure involvement T1 and T2 without lymph node or distant metastasis. Patients with missing data or patients with a history of additional malignancy at the time of diagnosis were excluded from the study (n=13). The data of the remaining 39 patients were further analyzed. Results: Fifteen patients (38.5%) were identified as having pT1 and 24 patients (61.5%), pT2. The mean tumor size was 16.8 mm and the mean invasion depth was 6.3 mm. Neck dissection was performed in 22 (56.4%) patients (6/15 pT1 patients and 16/24 pT2 patients). Lymph node involvement was reported in two (9.09%) of 22 patients. Both patients had pT2 stage tumors. Recurrence was observed in one patient (patient with pT2 tumor). The 5-year survival rate was calculated as 82.05%. Conclusion: In early-stage SCC of the lower lip, a tumor size greater than 21.5 mm and depth of tumor invasion greater than 7 mm are associated with increased neck metastasis. Elective neck dissection should be performed in these high-risk patients.