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CC BY 4.0 · Arch Plast Surg 2023; 50(04): 377-383
DOI: 10.1055/a-2095-6885
Pediatric/Craniomaxillofacial/Head & Neck
Original Article

Appropriate Surgical Margins for Excision of Squamous Cell Carcinoma of the Lower Lip

Jung Hyun Hong 
1   Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine, Busan, Korea
,
Chan Woo Jung 
1   Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine, Busan, Korea
,
Hoon Soo Kim 
2   Department of Dermatology, Pusan National University Hospital, Busan, Korea
,
Yong Chan Bae 
1   Department of Plastic and Reconstructive Surgery, Pusan National University, School of Medicine, Busan, Korea
3   Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
› Author Affiliations
Funding This work was supported by a 2-year Research Grant of Pusan National University.
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Abstract

Background Squamous cell carcinoma (SCC) is the most common malignancy on the lower lip. Surgical excision, the standard treatment for SCC, requires full-thickness excision. However, no consensus exists about the appropriate surgical margin. Therefore, we investigated the appropriate surgical margin and excision technique by analyzing 23 years of surgical experience with lower-lip SCC.

Methods We reviewed 44 patients with lower-lip SCC who underwent surgery from November 1997 to October 2020. Frozen biopsy was performed with an appropriate margin on the left and right sides of the lesion, and the margin below the lesion was the skin above the sulcus boundary. If the frozen biopsy result was positive, an additional session was performed to secure a negative margin. Full-thickness excision was performed until the final negative margin. In each patient, the total number of sessions performed, final surgical margin, and recurrence were analyzed.

Results Forty-one cases ended in the first session, 2 ended in the second session, and 1 ended in the third session. The final surgical margins (left and right; n = 88) were 5 mm (66%), 7 mm (9%), 8 mm (2.3%), 10 mm (20.4%), and 15 mm (2.3%). During an average follow-up of 67.4 months (range, 12–227 months), recurrence occurred in one patient.

Conclusion The final surgical margin was 5 mm in 66% (58/88) of the cases, and 97.7% (86/88) were within 10 mm. Therefore, we set the first frozen biopsy margin to 5 mm, and we suggest that a 5-mm additional excision is appropriate when frozen biopsy results are positive.

Keywords

margins of excision - lip cancer - squamous cell carcinoma

Authors' Contributions

Conceptualization: Y.C.B. Writing - original draft: J.H.H. Methodology: writing - review & editing: H.S.K. and C.W.J.


Ethical Approval

The study was approved by the Institutional Review Board of Pusan National University Hospital (IRB no.: 2203-011-112) and was performed in accordance with the principles of the Declaration of Helsinki.


Patient Consent

The patients provided written informed consent for the publication and the use of their images.




Publication History

Received: 18 April 2022

Accepted: 05 May 2023

Accepted Manuscript online:
17 May 2023

Article published online:
02 August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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