Abstract
The aim of this study was to detect lower lip squamous cell carcinomas (SCC) that had metastasized to the lymph nodes and to evaluate if neck dissection was necessary for patients with T1 or T2-stage lip cancer after a sentinel lymph node biopsy (SLNB). The study was conducted as a prospective clinical study to detect occult neck metastases in patients with T1 or T2 stage SCC of the lower lip. Thirty-one patients were eligible and underwent echo-ultrasound, computer tomography, magnetic resonance and lymphoscintigraphy (LSG) as diagnostic procedures. LSG was performed on the same day as the surgical procedure, after intradermal injection of 37 Mbq Tc99m-Sn-colloid/mL at four peritumoral sites. In patients with positive LSG results, the sentinel lymph nodes were extracted surgically. The risk factors for cancer development were sun exposure and smoking. The highest accuracy for detecting lymph node enlargements was achieved with magnetic resonance imaging (MRI; 80.7%). LSG showed excellent sensitivity (100%) and negative predictive value (NPV; 100%). Overall, occult metastases were diagnosed with an SLNB in eight (25.8%) patients. According to the results, with great caution, we suggest that an SLNB is reasonable to initiate only for patients with positive sentinel nodes by positive LSG, to be used as a lower morbidity approach for selected patients with T1 and T2 stage cancers.
Highlights
Squamous cell carcinoma (SCC) of the lower lip accounts for 25% of all oral cancers [1,2]
Our study aimed to analyze lower lip SCC tumors that had metastasized to the lymph nodes, to evaluate the accuracy of diagnostic tools for lymph node enlargements (echo-ultrasound, magnetic resonance imaging (MRI), Computer tomography (CT) and lymphoscintigraphy (LSG)), and show if elective or supraomohyoid neck dissection was necessary for patients with T1 or T2-stage lip cancer, to evaluate the applicability of the sentinel lymph node biopsy (SLNB) concept for T1 and T2 SCC of the lower lip
The current study aimed to detect lower lip SCC tumors that had metastasized to the lymph nodes, to evaluate the accuracy of the diagnostic tools for lymph node enlargements and to answer the thesis of whether elective or supraomohyoid neck dissection was necessary for patients with T1 or T2-stage lip cancer after evaluation of the SLNB
Summary
Squamous cell carcinoma (SCC) of the lower lip accounts for 25% of all oral cancers [1,2]. It is an epithelial malignant, infiltrating and destructive tumor with metastatic potential that can invade the deep muscle and mandible and can metastasize to the neck lymph nodes or blood [3]. Of all cases involve the lower lip [5] It is more frequent in male than female patients; patients aged over 45 years; those with chronic sun exposure, and chronic smoking and alcohol-drinking habits [1,6]; and in patients with accompanied systemic lupus erythematosus [7,8].
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