Lower lip squamous cell carcinoma in patients with photosensitive disorders: Analysis of cases treated at the Brazilian National Cancer Institute (INCA) from 1999 to 2012.

Jfp Borges,Pas De Faria,Rm Albano,Vg Bernardo,Sqc Lourenco,Lfr Pinto,F Dias,Nd Lanaro

doi:10.4317/medoral.21960

Abstract

BackgroundLower lip squamous cell carcinoma (LLSCC) is a common malignancy of the head and neck, being mainly a consequence of a chronic exposure to ultraviolet (UV) light solar radiation. Here, we evaluated the clinicopathological profile of patients with photosensitive disorders (xeroderma pigmentosum, lupus erythematosus and albinism) that developed LLSCC.Material and MethodsData from patients who had a diagnosed LLSCC with a prior xeroderma pigmentosum, lupus erythematosus or albinism diagnosis that were treated at INCA from 1999 to 2012 were collected from patients’ medical records (n=16). The control group was composed of 68 patients with LLSCC without a medical history of photosensitivity. The clinicopathological data of this study population were collected and the association between these variables was analyzed by Fisher’s exact test. Survival curves were constructed using the Kaplan–Meier method and compared by log-rank test. All statistical analyses were performed using SPSS statistics package.ResultsThe mean age of patients in the photosensitive and non-photosensitive groups was 42 years and 67 years, respectively (p<0.0001). A previous history of malignant diseases was more common in the photosensitive group (p=0.001). In both groups, most tumors showed a pathological stage I/II disease. Overall and cancer-specific survival were not statistically different. However, disease-free interval showed a significant difference (p=0.01) between the photosensitive and non-photosensitive patients.ConclusionsPhotosensitive patients presented LLSCC at earlier age but it usually was not the primary tumor in these patients. Furthermore, a more aggressive pathological behavior was not seen when compared with tumors from non-photosensitive patients. The disease-free interval was lower in photosensitive patients, as expected. Key words:Lip cancer, Xeroderma Pigmentosum, Albinism, Lupus erythematosus.

Highlights

Cancer of the lip and oral cavity accounted for 300,000 cases in 2012 (2.1% of the world’s total) [1]
There was a significant difference between the mean age at lower lip cancer diagnosis in the photosensitive group (42 ± 22.8 years, range: 11 – 77 years) and nonphotosensitive group (66.7± 14.4 years, range: 32 – 99 years, p = 0.001). ln the photosensitive group, a positive history of previous malignancy was more common when compared with the non-photosensitive group (p= 0.001)
Other groups had already shown the development of Lower lip squamous cell carcinoma (LLSCC) in albino patients previously affected by skin cancer [12,13], and Nico and coworkers stated that patients with LE may present previous tumors in malar, ear and scalp regions [14]

Summary

Introduction

Cancer of the lip and oral cavity accounted for 300,000 cases in 2012 (2.1% of the world’s total) [1]. Most tumors showed a pathological stage I/II disease. Disease-free interval showed a significant difference (p=0.01) between the photosensitive and non-photosensitive patients.

Results

Conclusion