Cruse C W, Radocha R F
Division of Plastic Surgery, University of South Florida College of Medicine, Tampa 33612.
Plast Reconstr Surg. 1987 Dec;80(6):787-91. doi: 10.1097/00006534-198712000-00005.
We reviewed 117 consecutive patients with squamous cell carcinoma of the lip. The retrospective review includes age, race, location, risk factors, TNM classification, histologic differentiation, treatment methods, recurrent disease, site of recurrence, and follow-up status. Results reveal prognosis is related to original tumor size, location, local recurrence, histologic grade, and presence of cervical metastasis. The presence of cervical lymph node disease reduces the survival from 90 to 50 percent; the survival after recurrent disease to the neck is 10 percent. When a prophylactic suprahyoid neck dissection shows involvement with tumor, 83 percent of patients have metastasis to cervical lymph nodes. The overall recurrence rate is 20 percent. Over 60 percent of the recurrent disease is due to tumors less than 4 cm in diameter. The local recurrence rate is 7 percent, but reexcision of the local recurrence gives a 75 percent cure rate. Aggressive surgical treatment is recommended for identifiably poor prognostic lesions and includes surgical excision, prophylactic suprahyoid neck dissection, and possible radical neck dissection.
我们回顾了117例连续性唇鳞状细胞癌患者。这项回顾性研究涵盖了年龄、种族、发病部位、危险因素、TNM分类、组织学分化程度、治疗方法、疾病复发情况、复发部位以及随访状态。结果显示，预后与原发肿瘤大小、部位、局部复发、组织学分级以及颈部转移的存在有关。颈部淋巴结疾病的存在使生存率从90%降至50%；颈部复发疾病后的生存率为10%。当预防性舌骨上颈部清扫显示有肿瘤累及，83%的患者有颈部淋巴结转移。总体复发率为20%。超过60%的复发疾病是由直径小于4厘米的肿瘤引起的。局部复发率为7%，但局部复发再次切除后的治愈率为75%。对于预后明显较差的病变，建议采取积极的手术治疗，包括手术切除、预防性舌骨上颈部清扫以及可能的根治性颈部清扫。
