Long-term outcome and subjective quality of life after surgical treatment of lower lip cancer.

OBJECTIVES: Squamous cell carcinoma of the lower lip represents a common type of cancer with a favourable prognosis. Different types of defect reconstruction after ablative surgery are described for maintenance of patients' quality of life.

MATERIALS AND METHODS: The study retrospectively evaluates the outcome of 105 patients treated for lower lip cancer. Oncological data as well as individual quality of life were investigated.

RESULTS: Cervical lymph node metastases rarely occurred (7.6 %) and were correlated to larger-sized tumours (p = 0.041). Only five patients (4.8) died related to the tumour disease, especially after lymph node metastasis and tumour recurrence (p < 0.001). The 5-year rates for recurrence-free, overall and disease-specific survival were 84.5, 61.2 and 93.9 %. Tumour recurrence correlated with a resection margin of less than 0.75 cm (p = 0.089). With view to postoperative quality of life, the modified Bernard-Fries technique showed the most unfavourable results, particularly referring to sensibility, paraesthesia, lip pursing and mouth opening compared to a stair-step and/or Abbe reconstructions.

CONCLUSIONS: Squamous cell carcinoma of the lower lip shows a very favourable prognosis. Neck dissection seems often negligible particularly in small tumours. Patients' functional quality of life after lip surgery depends on the size of the primary and the used technique. Stair-step and/or Abbe reconstructions should be preferred to a Bernard-Fries technique in comparable defect sizes.

CLINICAL RELEVANCE: Proper treatment of lower lip cancer provides favourable prognosis and preserves patients' functional and aesthetic quality of life.