title: A comparison of results after radiotherapy and surgery for stage I squamous cell carcinoma of the lower lip.
abstract: BACKGROUND
  Controversy still exists as to whether radiotherapy or surgery is the preferable therapeutic modality for stage I squamous cell carcinoma of the lower lip. Therefore, a retrospective study was undertaken to compare the results of both treatment modalities.
  
  
  METHODS
  The results of 90 patients who received radiotherapy and 166 patients who underwent surgery as the primary form of treatment for their stage I primary squamous cell carcinoma of the lower lip were evaluated. Tumor size and histological grade of differentiation were assessed.
  
  
  RESULTS
  Local control rates were the same with radiotherapy or surgery. Overall survival rates for both groups of patients were similar as well. Disease-free survival rates in the patients who underwent radiotherapy were significantly lower compared with the surgically treated group. This was due to a higher occurrence of regional metastases in the patients who received radiotherapy. Univariate analysis showed that irradiated patients had a statistically significant greater tumor size. The difference of histological differentiation between the groups was also statistically significant, the poorly differentiated being more common in the irradiated group. Multivariate analysis showed that only tumor size carried significant independent prognostic information.
  
  
  CONCLUSIONS
  The cure rates of stage I squamous cell carcinoma of the lower lip are favorable whether treated by radiotherapy or surgery, and local control rates are similar. The radiotherapeutic treated group showed an increased incidence of cervical metastases, which was due to the more advanced tumor size in these patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Medisch Centrum Leeuwarden, Henri Dunantweg 2, 8934 AD Leeuwarden, The Netherlands.
authors.forename: J G
authors.initials: JG
authors.lastname: de Visscher
authors.forename: G
authors.initials: G
authors.lastname: Botke
authors.forename: J A
authors.initials: JA
authors.lastname: Schakenraad
authors.forename: I
authors.initials: I
authors.lastname: van der Waal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008048:Lip Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome