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唇癌:临床表现、手术治疗及预后:来自丹麦的108例病例系列

Lip carcinoma: clinical presentation, surgical treatment, and outcome: a series of 108 cases from Denmark.

作者信息

Kristensen Rasmus N, Stemann Andersen Peter, Lock-Andersen Jørgen

机构信息

a Department of Plastic Surgery , Roskilde Hospital, Copenhagen University Hospital , Denmark.

出版信息

J Plast Surg Hand Surg. 2017 Oct;51(5):342-347. doi: 10.1080/2000656X.2016.1270215. Epub 2017 Jan 13.

Abstract

OBJECTIVE

Lip carcinomas are among the most common malignant tumours of the head and neck region but reports on the course and outcome of this disease are mainly based on Mediterranean, South American, and Oceanian populations. The aim of the study was to describe the treatment and outcome of patients with lip carcinoma at a Danish department of plastic surgery.

METHOD

We conducted a single institution retrospective cohort study including patients with primary cancer of the lips including squamous cell (SCC), basal cell (BCC), and basosquamous carcinomas (BSC) in a 5-year period.

RESULTS

We included 108 consecutive patients. Median age was 72 years (range 28 -98) and 58% were male. Seventy patients (65%) were diagnosed with SCC, 36 (33%) BCC, and 2 (2%) BSC. The majority of lesions were stage T1 (84%) and T2 (11%). An unexpected total of 35 (32%) patients experienced wound healing problems; whereof 19 (54%) classified as mild (not demanding treatment), 10 (29%) as moderate (non-functional surgical corrections or medical treatment of infection needed) and 6 (17%) experienced severe dehiscence (requiring surgical intervention for functional improvement). Total defect size ≥20 mm and full thickness excision was directly correlated to the risk of early postoperative complications (p-value: 0.03 and 0.04). Three patients (2/36 with BCC; 6% and 1/70 with SCC; 1%) developed local recurrence and five patients with SCC (5/70; 7%) developed regional lymph node metastases. One patient (1%) died from metastatic SCC.

CONCLUSION

This study confirms that lip carcinoma is associated with a risk of recurrence and mortality. However, the risk of wound complications is notable compared to other series.

摘要

目的

唇癌是头颈部最常见的恶性肿瘤之一,但关于这种疾病的病程和转归的报告主要基于地中海地区、南美洲和大洋洲人群。本研究的目的是描述丹麦一家整形外科科室唇癌患者的治疗情况和转归。

方法

我们进行了一项单机构回顾性队列研究,纳入了5年内患有原发性唇癌的患者,包括鳞状细胞癌(SCC)、基底细胞癌(BCC)和基底鳞状细胞癌(BSC)。

结果

我们纳入了108例连续患者。中位年龄为72岁(范围28 - 98岁),58%为男性。70例(65%)诊断为SCC,36例(33%)为BCC,2例(2%)为BSC。大多数病变为T1期(84%)和T2期(11%)。出乎意料的是,共有35例(32%)患者出现伤口愈合问题;其中19例(54%)为轻度(无需治疗),10例(29%)为中度(需要进行非功能性手术矫正或抗感染治疗),6例(17%)出现严重裂开(需要手术干预以改善功能)。总缺损大小≥20 mm和全层切除与术后早期并发症风险直接相关(p值:0.03和0.04)。3例患者(BCC患者中2/36;6%,SCC患者中1/70;1%)发生局部复发,5例SCC患者(5/70;7%)发生区域淋巴结转移。1例患者(1%)死于转移性SCC。

结论

本研究证实唇癌与复发和死亡风险相关。然而,与其他系列研究相比,伤口并发症的风险较为显著。

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