title: Cervical lymph node metastases and T1 squamous cell carcinoma of the lips.
abstract: OBJECTIVE
  The occurrence of cervical lymph node metastasis is a major prognostic factor for head and neck squamous cell carcinoma (SCC) of the lip. This study focuses on patients with T1 stage tumours,in order to describe the prevalence of metastatic lymphadenopathies.
  
  
  METHODS
  A multicenter retrospective study was performed in three tertiary care referral centers and included 59 patients surgically treated for T1 stage SCC of the lips from January 1996 to December 2006. This surgical treatment concerned the tumour, with cervical neck dissection when lymph node metastasis was suspected.
  
  
  RESULTS
  Cervical lymph node metastasis was found and histologically proven in 7 patients (11.9% of the cases, pN+ group; 95% confidence interval, 3.6 to 20.2%) during follow-up, never at the time of diagnosis. Metastasis appeared 13.3 ± 7.9 months (min. 5.3 months, max. 29.1 months) after the initial treatment and involved the IB level in all cases. Tumour progression was significantly longer in the pN+ group compared to patients with no lymph node metastases (sN-group). The pN+ group also had a significantly higher proportion of poorly or moderately differentiated tumours, and a significant decrease in overall survival, disease-free survival, and disease-specific survival.
  
  
  CONCLUSIONS
  Lymph node metastasis occurs in roughly 12% of T1 stage SCC of the lips, and the management of neck lymph node areas is necessary. A randomized trial is needed to determine the proportion of occult lymph node metastases in T1N0 patients and the impact of this therapeutic procedure on survival.
authors.forename: N
authors.initials: N
authors.lastname: Bon-Mardion
authors.forename: D
authors.initials: D
authors.lastname: De Raucourt
authors.forename: E
authors.initials: E
authors.lastname: Babin
authors.forename: J P
authors.initials: JP
authors.lastname: Rame
authors.forename: D
authors.initials: D
authors.lastname: Dehesdin
authors.forename: O
authors.initials: O
authors.lastname: Choussy
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008048:Lip Neoplasms / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck