title: Early-stage squamous cell carcinoma of the lip: the Australian experience and the benefits of radiotherapy in improving outcome in high-risk patients after resection.
abstract: BACKGROUND
  The purpose of this study was to analyze the outcome of Australian patients treated for early lip cancer.
  
  
  METHODS
  Data on 217 patients with T1 to T2 squamous cell carcinoma (SCC) of the lip and treated with radical intent were analyzed.
  
  
  RESULTS
  The addition of local adjuvant radiotherapy in patients with a close/positive margin was associated with a significant improvement in relapse-free survival (RFS; p = .008). Tumor thickness (≤4 mm vs >4 mm) was also significantly associated with RFS (p = .01). The 5-year RFS was 51% after surgery, 87% after radiotherapy, and 92% after adjuvant radiotherapy.
  
  
  CONCLUSIONS
  Patients with a tumor thickness >4 mm experienced an increased risk of recurrence, especially nodal. Compared with patients having any radiotherapy, those undergoing surgery experienced a higher rate of locoregional recurrence. The addition of adjuvant radiotherapy in patients with inadequate excision significantly decreased the risk of recurrence.
authors.affiliation: Head and Neck Cancer Service, Crown Princess Mary Cancer Centre, University of Sydney, Westmead, Sydney, Australia.
authors.forename: Maria
authors.initials: M
authors.lastname: Najim
authors.forename: Shamira
authors.initials: S
authors.lastname: Cross
authors.forename: Val
authors.initials: V
authors.lastname: Gebski
authors.forename: Carsten E
authors.initials: CE
authors.lastname: Palme
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Morgan
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Veness
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008048:Lip Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant / Q000379:methods* / Q000401:mortality; D011882:Radiotherapy, High-Energy / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult