Treatment of squamous cell carcinoma of the lip

Tumors of the lip are squamous cell carcinomas in 95% of the cases. Also, in 95% of the cases they arise on a vermilion of the lower lip, because of greater exposure of the lower lip vermilion to direct, cumulative UV radiation which is main etiologic factor in development of squamous cell carcinoma. We have reviewed patients that have been treated for lower lip carcinoma at the Department for Maxillofacial surgery, University hospital "Dubrava", from 1990 to 2007. Most common surgical procedure was V-shaped excision of the lip with or without vermilionectomy. For more extensive tumors we used some of the reconstruction methods with local or distant flaps (Webster-Bernard, Karapandzić, free flap). Neck dissection was performed only in patients with clinically evident metastasis or large carcinoma. Although regional metastasis is rare, it significantly lowers five-year survival. Also, we found worse outcome in patients that have been treated previously elsewhere and came for surgical therapy because of recurrent/residual tumor or neck metastasis in comparison to those that were initially treated at the Department of Maxillofacial surgery.