Oral oncology · 2025
Treatment and outcome for 2,111 patients with vermilion lip squamous cell carcinoma: A nationwide, population-based study from the SweHNCR.
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Hafström A, Hammerlid E, Beran M, Olin M, Högmo A, Farnebo L
Аннотация
BACKGROUND AND IMPORTANCE: The major risk factor for vermilion lip squamous cell carcinoma (vlSCC) is excessive sunlight exposure. Population-based studies on treatment and outcome are lacking.
METHODS: This is a nation-wide, population-based study of treatment and outcome from prospectively recorded data for 2,111 vlSCC registered in the Swedish Head and Neck Cancer Register (SweHNCR) diagnosed 2008-2022.
RESULTS: The age standardized incidence increased with 34 % between 2008 and 2022, from 1.14 to 1.53 per 100,000 (19 % for males and 55 % for females). Median age at diagnosis was 76 years and 72.4 % had good performance status. Males predominated (57.1 %). Lower lip vlSCC comprised 82.6 % and upper 8.6 %. Most had T1 (81.7 %) or T2 (13.5 %) tumors and few had regional (2.7 %) or distant (0.1 %) metastases. The 5-year observed overall survival was 70.5 % (95 % CI 68.4-72.6) and relative survival 90.8 % (95 % CI 88.2-93.7). Treatment data were registered in 1,948 cases and 97.5 % (1,900) had a curative intent, whereof 88.5 % had surgery, 7.3 % radiotherapy, and 4.2 % combination treatment. Recurrences were registered in 5.6 % (48.6 % local, 42.1 % regional) whereof 15.9 % after three years. Stage I recurred after median 17 (IQR 9-28) months whereas stage II and III after 10 months (7-17 and 9-13, respectively). Advanced age (p < 0.001), poor performance status (p < 0.001), male sex (p = 0.002), high stage (p = 0.041), and only radiotherapy (p = 0.007) remained as independent prognostic factors for mortality.
CONCLUSION: Females had higher incidence increase than males. Advanced age, poor performance status, male sex, advanced disease, and radiotherapy only were independent prognostic factors for mortality.
METHODS: This is a nation-wide, population-based study of treatment and outcome from prospectively recorded data for 2,111 vlSCC registered in the Swedish Head and Neck Cancer Register (SweHNCR) diagnosed 2008-2022.
RESULTS: The age standardized incidence increased with 34 % between 2008 and 2022, from 1.14 to 1.53 per 100,000 (19 % for males and 55 % for females). Median age at diagnosis was 76 years and 72.4 % had good performance status. Males predominated (57.1 %). Lower lip vlSCC comprised 82.6 % and upper 8.6 %. Most had T1 (81.7 %) or T2 (13.5 %) tumors and few had regional (2.7 %) or distant (0.1 %) metastases. The 5-year observed overall survival was 70.5 % (95 % CI 68.4-72.6) and relative survival 90.8 % (95 % CI 88.2-93.7). Treatment data were registered in 1,948 cases and 97.5 % (1,900) had a curative intent, whereof 88.5 % had surgery, 7.3 % radiotherapy, and 4.2 % combination treatment. Recurrences were registered in 5.6 % (48.6 % local, 42.1 % regional) whereof 15.9 % after three years. Stage I recurred after median 17 (IQR 9-28) months whereas stage II and III after 10 months (7-17 and 9-13, respectively). Advanced age (p < 0.001), poor performance status (p < 0.001), male sex (p = 0.002), high stage (p = 0.041), and only radiotherapy (p = 0.007) remained as independent prognostic factors for mortality.
CONCLUSION: Females had higher incidence increase than males. Advanced age, poor performance status, male sex, advanced disease, and radiotherapy only were independent prognostic factors for mortality.