title: Squamous cell carcinoma of the lip: depth of invasion, local recurrence and regional metastases. Experience of a rural multidisciplinary head and neck unit.
abstract: BACKGROUND
  The internationally recognised American Joint Committee on Cancer (tumour-node-metastasis) staging system utilises tumour size to determine stage. Other factors (i.e. tumour depth) may provide additional prognostic information.
  
  
  METHODS
  A thorough retrospective analysis was performed of 68 patients with primary lip squamous cell carcinoma operated on or discussed by the Darling Downs Health Service between 2005 and 2013.
  
  
  RESULTS
  Twelve patients developed lymphatic spread. There was a statistically significant increased risk of nodal metastasis in: patients with tumours of increased thickness (U = 103.50; degrees of freedom = 68; p < 0.001), those with a larger overall tumour size (U = 163.50; degrees of freedom = 68; p = 0.005) and patients living further from the treatment centre (U = 199.00; degrees of freedom = 68; p = 0.018).
  
  
  CONCLUSIONS
  It may be reasonable that other factors are considered for staging of lip squamous cell carcinomas, in combination with tumour-node-metastasis staging. Depth of invasion may have utility in prognosis and treatment; however, larger prospective analysis needs to be performed. Patients living in a more rural setting presented with more advanced disease, suggesting an ongoing rural-metropolitan gap in healthcare.
authors: Ear,Nose and Throat Surgical Department,Toowoomba General Hospital,Queensland,Australia.
authors: A
authors: A
authors: Pastuszek
authors: Ear,Nose and Throat Surgical Department,Toowoomba General Hospital,Queensland,Australia.
authors: M
authors: M
authors: Hanson
authors: Ear,Nose and Throat Surgical Department,Toowoomba General Hospital,Queensland,Australia.
authors: R
authors: R
authors: Grigg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008048:Lip Neoplasms / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D011793:Queensland; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population; D000077195:Squamous Cell Carcinoma of Head and Neck; D055815:Young Adult
keywords: Carcinoma; Epidermoid; Lip; Planocellular; Prognosis; Squamous; Squamous Cell Carcinoma