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Lip Cancer

Understanding the Anatomy

10_lipsThe upper and lower lips are the gateway to the rest of the oral cavity. They are responsible for protecting the mouth and for keeping food and drink in the mouth when you are eating or drinking. They also play a role in articulation (clear sounds) when you speak.

In reality, the upper lip extends from the bottom part of the nose, and the lower lip starts at the mental crease (top part of the jawbone). However, cancers that arise on the part of the upper and lower lips that look like facial skin are grouped in with skin cancer. Cancers on the pink part of the lips (mucosal lips) are grouped in with oral cavity cancers and will be discussed here.

The mucosal lip starts from the vermillion border (junction of facial skin with the pink lip) and ends at the point where the upper and lower lips meet when the mouth is closed.

On each side of the mouth is the commissure. This is where the upper and lower mucosal lips come together. Cancers in this part of the lip are very rare.1Zitsch RP. Carcinoma of the lip. Otolaryngol Clin North America.1993;26;265-277.

The mucosal lip is made up of squamous epithelium. There are a number of minor salivary glands under that layer. There is also a muscle layer. The upper and lower lips transition with the “labial mucosa,” which extends to the upper and lower gingiva (gums).

References

1 Zitsch RP. Carcinoma of the lip. Otolaryngol Clin North America.1993;26;265-277.

2 Piccirillo JF, Costas I, Reichman ME. Chapter 2: Cancers of the head and neck. Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.

3 Petersen PE, Oral cancer prevention and control – The approach of the World Health Organization, Oral Oncol. 2008.

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8 Civantos FJ, Zitsch RP, Schuller DE, Agrawal A, Smith RB, Nason R, Petruzelli G, Gourin CG, Wong RJ, Ferris RL, El Naggar A, Ridge JA, Paniello RC, Owzar K, McCall L, Chepeha DB, Yarbrough WG, Myers JN. Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol. 2010 Mar;28(8):1395-400.

9 Koch WM, Choti MA, Civelek AC, Eisele DW, Saunders JR. Gamma probe-directed biopsy of the sentinel node in oral squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 1998;124:455-9.

10 Shoaib T, Soutar DS, MacDonald DG, Camilleri IG, Dunaway DJ, Gray HW, McCurrach GM, Bessent RG, MacLeod TIF, Robertson AG 2001. The accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck. Cancer. 91:2077-2083.

11 Kademani D. Oral cancer. Mayo Clinic proceedings. Mayo Clinic. Jul 2007;82(7):878-887.

12 Funk GF, Karnell LH, Robinson RA, Zhen WK, Trask DK, Hoffman HT. Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report. Head Neck. 2002 Feb;24(2):165-80.

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14 Listl S, Jansen L, Stenzinger A, Freier K, Emrich K, et al. Survival of patients with oral cavity cancer in Germany. PLoS ONE.2013;8(1):e53415.

15 Anneroth G, Batsakis J, Luna M. Review of the literature and a recommended system of malignancy grading in oral squamous cell carcinomas. Scand J Dent Res. 1987;95;229-249.

16 Edge SB, et al. The AJCC Cancer Staging Manual – Seventh Edition. American Joint Committee on Cancer 2010.

17 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed November 9, 2016. To view the most recent and complete version of the guideline, go online to www.NCCN.org.

18 Jan JC, Hsu WH, Liu SA, Wong YK, Poon CK, Jiang RS, Jan JS, Chen IF. Prognostic factors in patients with buccal squamous cell carcinoma: 10-year experience. J Oral Maxillofac Surg. 2011 Feb;69(2):396-404.

19 Pradhan SA, Rajpal RM. Marginal mandibulectomy in the management of squamous cancer of the oral cavity. Indian J Cancer. 1987;24:167-171.

20 Baker SR, Krause CJ. Carcinoma of the lip. Laryngoscope. 1980 Jan;90(1):19-27.

21 Maddox WA, Urist MM. Histopathological prognostic factors of certain primary oral cavity cancers. 1990 Dec;4(12):39-42; discussion 42,45-6.