title: Nd:YAG laser therapy of carcinoma lip (stage I squamous cell carcinoma): a retrospective evaluation.
abstract: OBJECTIVE
  To asses the efficacy of Nd:YAG laser for stage I squamous cell carcinoma of the lip. To the authors' knowledge this is the first reported study on this subject.
  
  
  METHODS
  Retrospective study design involving treatment of 46 patients of either sex of stage I squamous cell carcinoma of lip over a 10-year period in a single tertiary care university teaching hospital with Nd:YAG laser.
  
  
  METHODS
  Nd:YAG laser ablation of lesions in lip was carried out in all the patients on an OPD basis with prior consent. A regular follow-up was maintained for a period of 5 years. A negative biopsy at the end of one month and one year was considered a treated case. The tabulated data was analysed statistically by "Kaplan Meier" method and "Log Rank" test. Also cosmetic and functional results were assessed by any sign of flow away after filling the oral cavity with water and postoperative integrity of facial nerve in accordance with "House Brackmann" classification.
  
  
  RESULTS
  In this series of 46 patients, 35 patients were disease free at the end of 3 years and this number further declined to 29 at the end of 5 years with 4 deaths and 2 more patients lost to follow-up. The statistical evaluation by Kaplan Meier method gives us an overall 5-year survival rate of 88.14% with a mean survival of 58 months. Further 8 patients required repeat laserization either for residual or recurrence of lesion. Also 2 patients had a lymph node metastasis during the follow-up period. Thus, by applying Kaplan Meier method recurrence-free survival (RFS) and disease-free survival was found to be 85.1% (mean: 55 months) and 73.34% (mean: 57 months respectively. Interestingly on applying Log Rank test it was observed that the site of the lip involvement, i.e. whether upper or lower had no influence on disease-free survival. It was also observed that history of tobacco intake did not influence the disease free survival either (Log Rank Test). Moreover the cosmetic results were excellent and with no significant complication observed.
  
  
  CONCLUSIONS
  The results reported here support the use of Nd:YAG laser for treatment of Stage I squamous cell carcinoma of lip in accordance with principles of minimal invasive and morbid surgery.
authors.affiliation: Institute of Medical Sciences & Sir Sunderlal Hospital, Banaras Hindu University, Varanasi, 221 005 Uttar Pradesh India.
authors.forename: Gautam Bir
authors.initials: GB
authors.lastname: Singh
authors.forename: Mallika
authors.initials: M
authors.lastname: Tiwari
authors.forename: H S
authors.initials: HS
authors.lastname: Shukla
authors.forename: Manoj
authors.initials: M
authors.lastname: Pandey
keywords: Carcinoma lip; Nd:YAG laser; Squamous cell carcinoma