Lip cancer experience in Mexico. An 11-year retrospective study.
Lip cancer is the most frequent malignant neoplasm of the oral cavity; however, there is no information available on the incidence of this type of cancer in Mexico. This study provides information about the clinico-pathological features of lip cancer patients admitted at a cancer hospital in Mexico City during an 11-year period and describes the treatment modalities performed and their results. A total of 113 patients were studied. There were 74 men (65.5%) and 39 women (34.5%), ranging in age from 14 to 106 years (mean 70 years). In 53 cases (46.9%) an association was found between the disease and chronic sun exposure. Additionally, positive smoking antecedents were recorded in 58 cases (51.3%). As 15 patients were followed for less than 1 month, they were excluded for further analysis. There were 82 cases (83.7%) of squamous cell carcinoma, 10 (10.2%) basal cell carcinomas, and one case (1%) each of adenocarcinoma NOS, melanoma, adenoid cystic carcinoma, Merkel cell carcinoma, lymphoepithelioma and angiosarcoma. We observed an incidence of malignant neoplasms in the upper lip of 33.7%, which is higher than most of the published series and may be due to the fact that in this series we included all histological types of lip cancers. Fifty percent of the cases were found in stages III and IV. Cervical lymph node metastases were found in 21% of patients with no previous treatment, and they developed in 5.3% after treatment. Our data suggest that tumoral size is directly related to the possibility of developing node metastases, as none of them occurred in patients T1, whereas 10 (62.5%) of the patients in T4 presented them. Seven deaths were documented (7.1%), five of which corresponded to squamous cell carcinoma, one to Merkel cell carcinoma, and one to adenocarcinoma. Deaths were directly related to the disease in six cases, and one patient died due to surgical complications. Distant metastases were found in only two patients, one of which coursed with an adenocarcinoma and the other with a Merkel cell carcinoma. Based on the present results, we suggest that the differences encountered with respect to other series, particularly the higher incidence found in women, the frequent presentation of this type of neoplasms in the upper lip, the wide variety of histopathological diagnoses and the high frequency of cases with cervical lymph node affection, should lead us to search for multi-modal treatment alternatives in this population.
Luna-Ortiz
Kuauhyama
K
Department of Head and Neck Surgery at the Instituto Nacional de Cancerología, Av. San Fernando # 22, Tlalpan, México, DF 14080, Mexico. kuauhyama@starmedia.com
Güemes-Meza
Agustín
A
Villavicencio-Valencia
Verónica
V
Mosqueda-Taylor
Adalberto
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008048:Lip Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D017678:Sex Distribution; D016019:Survival Analysis