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Abstract
Introduction. Lip cancers are uncommon among black people but not unusual. The objectives of this study were to describe the epidemiological, clinical and therapeutic aspects of lip cancers at ENT Department of National University Hospital of Fann in Dakar, Senegal. Patients and methods. We performed a retrospective and descriptive study at ENT Department of Fann teaching Hospital in Dakar, Senegal, over a period of seven years, among patients with lip cancers confirmed by the pathology. The following data were studied: age, gender, past medical history, alcohol and tobacco intake, oral hygiene, the location of the lesions and their extensions, pathological findings, TNM classification, postoperative complications and mortality. Results. 19 cases were collected. The mean age of patients was 51 years, with a sex ratio of 1.4. Bad oral hygiene was the main risk factor followed by prolonged sunlight exposure. The lower lip was the main location of the lesion (73.7%). The budding ulcerative appearance was predominant (73.68%). Squamous cell carcinoma was found in all our patients. 68.42% of our patients were classified T3-T4. 63.15% of our patients underwent surgical resection of the tumor. The most common technique of reconstruction was Estlander flap (25%). Morbidity and mortality were respectively 50% and 31.6%. The global survival rate at one and three years was 85.7%. Conclusion. Lips cancers are relatively uncommon tumors in the black people. In our context, patients consult at advanced stages, making their treatment more difficult.
ABSTRACT
Introduction. Les cancers de la lèvre sont rares chez le mélanoderme mais non exceptionnels. Les objectifs de cette étude étaient de décrire les aspects démographiques, cliniques et thérapeutiques des cancers de la lèvre au CHNU de Fann (Dakar, Sénégal). Patients et méthodes. Étude rétrospective descriptive sur une période de 7 ans à la Clinique ORL du CHNU de Fann (Dakar, Sénégal), chez des patients ayant un cancer de la lèvre confirmé à l’examen histopathologique. Les paramètres étudiés étaient l’âge, le sexe, les antécédents, l’intoxication alcoolo-tabagique, l’état bucco-dentaire, la localisation des lésions et leurs extensions, les résultats anatomopathologiques de la pièce opératoire, la classification TNM, les complications postopératoires et la mortalité. Résultats. 19 patients ont été recrutés. L’âge moyen était de 51 ans avec un sex ratio de 1,4. Le mauvais état bucco-dentaire était le premier facteur de risque, suivi de l’exposition solaire prolongée. On retrouvait majoritairement un aspect ulcéro-bourgeonnant (73,68%). La localisation labiale inférieure était la plus fréquente (73,7%). Le carcinome épidermoïde était retrouvé chez tous nos patients. 68,42% des patients étaient classés T3-T4. Le traitement chirurgical a concerné 63,15% des patients. La reconstruction par lambeau de Estlander était la plus utilisée (25%). La morbidité et la mortalité ont été respectivement de 50% et 31,6%. La survie globale des patients opérés, à un an et trois ans était de 85,7%. Conclusion. Les cancers de la lèvre sont des tumeurs relativement rares chez le sujet noir. Dans notre contexte, les patients consultent à des stades avancés rendant leur prise en charge difficile.
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References
- Diombana ML, Mohamed AG, Kussner H, Sine B, Penneau M. Tumeurs de la lèvre et des joues au service de stomatologie de l’hôpital national de KATI (république du Mali) - A propos de 44 cas. Med Afr Noire. 1996; 43:8-9.
- Ben Slama L. Carcinomes des lèvres. Rev Stomatol Chir Maxillofac. 2009; 248:1-6.
- Biasoli ER, Valente VB, Mantovan B et al. Lip Cancer: A Clinicopathological Study and Treatment Outcomes in a 25-Year Experience. J Oral Maxillofac Surg 2016; 74:1360-1367.
- Chekrine T, Benhmidoune MA, Benchakroun N. Carcinomes de la lèvre : à propos de 41 cas. Cancer/Radiothérapie. 2008; 12:739-40.
- Luna-Ortiz H, Güemes-Mez A, Villavicencio V et al. Lip cancer experience in Mexico. An 11-year retrospective study. Oral Oncology. 2004; 40:992-9.
- Fernandez-Angel I, Rodriguez-Archilla A, Aneiros Cachaza J et al. Markers of metastasis in lip cancer. Eur J Dermatol. 2003; 13:276–9.
- Effiom OA, Adeyemo WL, Omitola OG et al. Oral Squamous Cell Carcinoma:A Clinicopathologic Review of 233 Cases in Lagos, Nigeria. J Oral Maxillofac Surg. 2008; 66:1595-9.
- Morgado de Abreu MAM, Panhoca da Silva OM, Pimentel DRN et al. Actinic cheilitis adjacent to squamous carcinoma of the lips as an indicator of prognosis. Rev Bras Otorrinolaringol. 2006; 72; 6:767-71.
- Ezzoubi M. La reconstruction après exérèse carcinologique des cancers des lèvres. (À propos de 100 cas). Rev Laryngol Otol Rhinol. 2005; 126:141-146.
- Ayachi S. La réparation des pertes de substance chirurgicales transfixiantes des lèvres (A propos de 48 cas). Rev Stomatol Chir Maxillofac. 2005; 106:17-18.
- Vukadinovic M, Jezdic Z, Petrovic M et al. Surgical Management of Squamous Cell Carcinoma of the Lip: Analysis of a 10-Year Experience in 223 Patients. J Oral Maxillofac Surg. 2007; 65:675-679.
- Dediol E, Luksić I, Virag M. Treatment of squamous cell carcinoma of the lip. Coll Antropol. 2008; 32:199-202.
- Ogura I, Amagasa T, Iwaki H et al. Clinicopathological study of carcinomas of the lip and the mucosa of the upper and lower lips. Int J Clin Oncol. 2001; 6:123–27.
- Chang JYF, Stewart JM, Cheng L et al. Upper lip nodule /Merkel cell carcinoma. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod. 2008; 105:549-53.
- Beauvillain de montreuil C, Dréno B, Tessier MH. Tumeurs bénignes et malignes des lèvres. EMC Oto-rhino-laryngologie 1998 ; 20-625-A-10.
- Lee J, Fernandez R, Jacksonville FL. Microvascular reconstruction of extended total lip defects. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod. 2007; 104:170-6.
- Zitsch RP, Lee BW, Smith RB. Cervical lymph node metastases and squamous cell carcinoma of the lip. Head Neck. 1999; 21:447–53.
- Bilkay U, Kerem H, Ozek C et al. Management of Lower Lip Cancer: A Retrospective Analysis of 118 Patients and Review of the Literature. Ann Plast Surg. 2003; 50:1.
- Thiam A, Diom ES, Diouf MS et al. Prise en charge du carcinome basocellulaire de la face du sujet noir : A propos de deux cas. Med Afr Noire. 2012; 59 (1): 28-29.
- Coppit GL, Lin DT, Burkey BB. Current concepts in lip reconstruction.Curr Opin Otolaryngol Head Neck Surg. 2004; 12:281–7.
- Salgarelli AC, Sartorelli F, Cangiano A, Pagani R, Collini M . Surgical Treatment of Lip Cancer: Our Experience with 106 Cases. J Oral Maxillofac Surg. 2009; 67:840-845.
References
Diombana ML, Mohamed AG, Kussner H, Sine B, Penneau M. Tumeurs de la lèvre et des joues au service de stomatologie de l’hôpital national de KATI (république du Mali) - A propos de 44 cas. Med Afr Noire. 1996; 43:8-9.
Ben Slama L. Carcinomes des lèvres. Rev Stomatol Chir Maxillofac. 2009; 248:1-6.
Biasoli ER, Valente VB, Mantovan B et al. Lip Cancer: A Clinicopathological Study and Treatment Outcomes in a 25-Year Experience. J Oral Maxillofac Surg 2016; 74:1360-1367.
Chekrine T, Benhmidoune MA, Benchakroun N. Carcinomes de la lèvre : à propos de 41 cas. Cancer/Radiothérapie. 2008; 12:739-40.
Luna-Ortiz H, Güemes-Mez A, Villavicencio V et al. Lip cancer experience in Mexico. An 11-year retrospective study. Oral Oncology. 2004; 40:992-9.
Fernandez-Angel I, Rodriguez-Archilla A, Aneiros Cachaza J et al. Markers of metastasis in lip cancer. Eur J Dermatol. 2003; 13:276–9.
Effiom OA, Adeyemo WL, Omitola OG et al. Oral Squamous Cell Carcinoma:A Clinicopathologic Review of 233 Cases in Lagos, Nigeria. J Oral Maxillofac Surg. 2008; 66:1595-9.
Morgado de Abreu MAM, Panhoca da Silva OM, Pimentel DRN et al. Actinic cheilitis adjacent to squamous carcinoma of the lips as an indicator of prognosis. Rev Bras Otorrinolaringol. 2006; 72; 6:767-71.
Ezzoubi M. La reconstruction après exérèse carcinologique des cancers des lèvres. (À propos de 100 cas). Rev Laryngol Otol Rhinol. 2005; 126:141-146.
Ayachi S. La réparation des pertes de substance chirurgicales transfixiantes des lèvres (A propos de 48 cas). Rev Stomatol Chir Maxillofac. 2005; 106:17-18.
Vukadinovic M, Jezdic Z, Petrovic M et al. Surgical Management of Squamous Cell Carcinoma of the Lip: Analysis of a 10-Year Experience in 223 Patients. J Oral Maxillofac Surg. 2007; 65:675-679.
Dediol E, Luksić I, Virag M. Treatment of squamous cell carcinoma of the lip. Coll Antropol. 2008; 32:199-202.
Ogura I, Amagasa T, Iwaki H et al. Clinicopathological study of carcinomas of the lip and the mucosa of the upper and lower lips. Int J Clin Oncol. 2001; 6:123–27.
Chang JYF, Stewart JM, Cheng L et al. Upper lip nodule /Merkel cell carcinoma. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod. 2008; 105:549-53.
Beauvillain de montreuil C, Dréno B, Tessier MH. Tumeurs bénignes et malignes des lèvres. EMC Oto-rhino-laryngologie 1998 ; 20-625-A-10.
Lee J, Fernandez R, Jacksonville FL. Microvascular reconstruction of extended total lip defects. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod. 2007; 104:170-6.
Zitsch RP, Lee BW, Smith RB. Cervical lymph node metastases and squamous cell carcinoma of the lip. Head Neck. 1999; 21:447–53.
Bilkay U, Kerem H, Ozek C et al. Management of Lower Lip Cancer: A Retrospective Analysis of 118 Patients and Review of the Literature. Ann Plast Surg. 2003; 50:1.
Thiam A, Diom ES, Diouf MS et al. Prise en charge du carcinome basocellulaire de la face du sujet noir : A propos de deux cas. Med Afr Noire. 2012; 59 (1): 28-29.
Coppit GL, Lin DT, Burkey BB. Current concepts in lip reconstruction.Curr Opin Otolaryngol Head Neck Surg. 2004; 12:281–7.
Salgarelli AC, Sartorelli F, Cangiano A, Pagani R, Collini M . Surgical Treatment of Lip Cancer: Our Experience with 106 Cases. J Oral Maxillofac Surg. 2009; 67:840-845.