[Evaluation of occult lymph node metastasis in lower lip cancers and approach to N(0) neck metastasis].

OBJECTIVES

In this study, we evaluated the incidence of occult lymph node metastasis and the approach to N0 necks in carcinoma of the lower lip.

PATIENTS AND METHODS

Sixty-eight patients who underwent surgery for squamous cell carcinoma of the lower lip were monitored for a minimum period of three years. All the patients were males (mean age 54 years; range 36 to 69 years). Preoperatively, 15 and 53 patients had N+ and N0 necks, respectively. Depending on the tumor localization, unilateral or bilateral suprahyoid neck dissections were performed. Nine patients underwent radical neck dissection following detection of metastasis on histopathologic examination.

RESULTS

Histopathologic examination revealed metastasis in four patients (4/15; 26%) with N+ necks and in five patients (5/53; 9.4%) with N0 necks. Four patients (6.7%) developed late cervical lymph node metastasis at level 3. No evidence of neck disease was encountered in 93% of patients.

CONCLUSION

Suprahyoid neck dissection appears to be effective in detecting occult lymph node metastasis. With improved surgical and histopathologic techniques and consideration of skip metastasis, more aggressive treatment approaches may be employed and better survival rates may be obtained.