Role of the Neck Dissection in Early‑Stage Lower Lip Cancers

Abstract

Background: In early-stage lip cancer, spread to cervical lymph nodes is extremely rare. Elective neck treatment options include  suprahyoid or supraomohyoid neck dissection, sentinel lymph node biopsy, or close follow-up.

Aim: In this study, our aim was to  investigate the effect of elective surgery on survival in patients operated for early-stage lip cancer.

Methods: Patients who underwent  surgical treatment for lower lip squamous cell carcinoma between 2005 and 2020 were  retrospectively analyzed. Age, gender, neck  dissection status (yes/no), clinical and pathological T stage of the tumor, grade, and  perineural invasion were recorded and 3-year and  5-year overall (OS) and disease-free survival (DFS) rates were estimated. 

Results:  Thirty patients were included: 20 patients had pT1 and  10 patients had pT2 tumors. Neck dissection was performed in 13 patients. The  5-year OS rate was 90.9% and 87.8% with and without  dissection, respectively. Neck dissection did not appear to affect OS (P = 0.534) in  these patients. The 5-year DFS rate was 96.4% in the  overall group, while it was 91.7% and 100% in patients who did or did not undergo  neck dissection, respectively (P = 0.756). 

Discussion:  Patients with or without neck dissection did not differ significantly in terms of OS  and DFS. Watchful waiting with regular ultrasound  imaging of the neck in patients with T1 and T2 lip tumors may be an appropriate  therapeutic option.