Second Events After Curative-Intent Treatment for Lip Cancer: Navigating the Path of Follow-Up Care

We aimed to investigate the pattern, risk, and treatment of subsequent events after curative-intent treatment of lip cancer.

This retrospective cohort study included 313 patients treated for lip cancer from 2011 to 2021 in a tertiary oncological center.

After a median follow-up time of 29.16 months, 145 (46.32%) patients presented with second primary tumors, 93% of which were skin carcinomas. Locoregional recurrence occurred in 7.9% of cases, with 2.5% with nodal recurrence. The 1-, 5-, and 10-year cumulative second primary tumor probabilities were 32.8%, 60.92%, and 70.92%, respectively. A higher risk was observed in elderly patients and basal cell carcinoma cases located on the cutaneous surface of the upper lip. Regional metastasis but not second primary tumors negatively impacted survival.

Our study helps fill a literature gap, structuring specific recommendations regarding evaluations and follow-up protocols for patients with lip cancer. Since cutaneous second primary tumors were the most common second event, standard skin examination is key. Age and histology were significant predictors for second primary tumors. For cases of locally advanced lip squamous cell carcinoma, standard guidelines for head and neck cancer must be followed.