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Treatment and outcome for 2,111 patients with vermilion lip squamous cell carcinoma : A nationwide, population-based study from the SweHNCR

Hafström, A. LU ; Hammerlid, E. ; Beran, M. ; Olin, M. LU ; Högmo, A. and Farnebo, L. (2025) In Oral Oncology 172.
Abstract

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... (More)

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.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Follow-up, Head and neck cancer, Incidence, Lip malignancy, Nation-wide, Population based, Squamous cell carcinoma, Survival, Vermilion lip
in
Oral Oncology
volume
172
article number
107818
publisher
Elsevier
external identifiers
  • pmid:41385845
  • scopus:105024603095
ISSN
1368-8375
DOI
10.1016/j.oraloncology.2025.107818
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025
id
bb5c0765-81d6-4884-8838-067f3bacb849
date added to LUP
2026-03-30 15:12:39
date last changed
2026-04-13 16:39:02
@article{bb5c0765-81d6-4884-8838-067f3bacb849,
  abstract     = {{<p>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 &lt; 0.001), poor performance status (p &lt; 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.</p>}},
  author       = {{Hafström, A. and Hammerlid, E. and Beran, M. and Olin, M. and Högmo, A. and Farnebo, L.}},
  issn         = {{1368-8375}},
  keywords     = {{Follow-up; Head and neck cancer; Incidence; Lip malignancy; Nation-wide; Population based; Squamous cell carcinoma; Survival; Vermilion lip}},
  language     = {{eng}},
  month        = {{12}},
  publisher    = {{Elsevier}},
  series       = {{Oral Oncology}},
  title        = {{Treatment and outcome for 2,111 patients with vermilion lip squamous cell carcinoma : A nationwide, population-based study from the SweHNCR}},
  url          = {{http://dx.doi.org/10.1016/j.oraloncology.2025.107818}},
  doi          = {{10.1016/j.oraloncology.2025.107818}},
  volume       = {{172}},
  year         = {{2025}},
}