Lip cancer and lower lip reconstruction
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概要
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The most common type of lip cancer is squamous cell carcinoma. The lower lip is affected far more frequently than the upper lip or commissure. The etiology of lip cancer is multifactorial and is connected with exposure to sun, smoking, and infection with human papillomaviruses. Lip cancers develop slowly and metastasize to the lateral cervical lymph nodes. The 5-year survival rate is 85％ to 99％ for stage T1N0, but it decreases markedly to 25％ to 50％ in patients who are N＋ at presentation. Several methods for treatment of SCC of the lip are available, including surgery, radiotherapy, chemotherapy, and combinations of those. The primary goals of treatment are generally removal of cancer load, prevention of relapse, and maintenance of quality of life. Primary management of SCC of the lip is complete surgical resection. Several surgical techniques and reconstructive approaches can be used for the lip reconstruction, depending on the size and location of the lesion and the needs for reconstruction. Management of the resulting lip defect remains a significant reconstructive challenge, requiring meticulous preoperative planning and careful choice of the surgical technique. Numerous reconstructive techniques by various flaps are used with a goal of obtaining acceptable oral function and good esthetic outcome. SCC of the lip generally has a favorable outcome. For lip cancers smaller than 2cm, cure rates of greater than 90％ may be expected. Successful treatment of SCC of the lip depends on early detection and treatment that leads to decreased morbidity and mortality. Because, in most instances, lip cancers are easily recognized they may be diagnosed at an early stage.
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