Role of Elective Neck Dissection in Early Stage Lip Cancers

To date, the management of the neck in early stage lower lip cancers remains controversial. The aim of this study is to investigate if prophylactic neck dissection is necessary in early stage lower lip cancers.

Charts of 11 patients who underwent surgery of the primary site and neck because of T1-2N0 lower lip cancer between 1997 and 2011 were retrospectively examined. Clinical stages, surgeries, histopatological examination results, and loco-regional recurrences were evaluated.

Of the 11 patients, 10 were male (90.9%) and 1 was female (9.09%). The follow-up time of these patients was between 24-168 months (mean, 56.6 months). There were 5 patients with clinically diagnosed T1N0 tumors and 6 patients with clinically diagnosed T2N0 tumors. Suprahyoid neck dissection was performed in 4/5 T1N0 patients and supraomohyoid neck dissection was performed in the remaining 1 patient. For T2N0 tumors, 4 suprahyoid, 1 supraomohyoid, and 1 comprehensive neck dissection was performed. Histopathological examination revealed no occult metastasis in any of the patients. In 1 patient who had lower lip resection and suprahyoid neck dissection for T1N0 lower lip cancer, a contralateral neck metastasis was detected 22 months postsurgery, and a comprehensive neck dissection was performed.

Our results show that in patients with T1N0 lower lip tumors, neck dissection may not be necessary; however, close follow-up is mandatory. Further researches with larger series dividing T2N0 tumors into subgroups for tumor size and thickness are necessary to determine neck treatment in these tumors.