Understanding the risk of metastasis in lower lip carcinoma: clinical insights and prognostic implications

BACKGROUNDS: Cutaneous squamous cell carcinoma accounts for the second most skin tumor and is mostly found in the head and neck area. Lymph nodal spreading appears in around 5% of all patients and worsens the prognosis as well as overall survival. Especially the tumor localisation in the lower lip is known for a higher risk of lymph nodal metastases. METHODS: Data of 71 patients suffering from cutaneous squamous cell carcinoma (CSCC) of the lower lip were analyzed retrospectively. Risk factors such as tumor size and depth of invasion and other histopathological findings were collected. Logistic regression analysis was performed to determine the value of different risk factors. RESULTS: One-third of all patients suffered from lymph nodal metastases. Poor differentiation was the strongest risk factor for lymph nodal spreading. Tumor diameter of more than 1.6 cm and depth of invasion greater than 0.85 cm were also considered as factors. Patients with G3 tumors had a 19.1 times higher risk for lymph nodal spreading. CONCLUSION: The lower lip location has a high risk for lymph node metastasis in CSCC. Overall, poor differentiation was the strongest factor associated with an increased risk of lymph node metastases in this patient cohort.