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How do you manage T1-2 SCC of the lip postoperatively?

In addition to positive margins, perineural/vascular/lymphatic invasion as listed by NCCN, would features such as close margins or high grade dysplasia at the margin prompt you to recommend reexcision or postop RT?
3 Answers
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Radiation Oncology · HCA South Atlantic
Answered on

In my practice, the decision to re-resect vs RT in patients with close margins or high grade dysplasia depends on the ability to identify and reliably resect close or dysplastic margins without risk of oral incompetence.

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Radiation Oncology · AV Strauss MD
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With all due respect to our surgical colleagues, it takes more time, certainly, there is more swelling and lip pain during radiation, but our functional and cosmetic results are much better with primary radiation.

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Radiation Oncology · Beaumont Hospital
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While re-excision is a viable option, cosmesis and verbal understanding are also critical.

Once the decision is made for radiation, a really nice option one not practiced as often these days is brachytherapy. Literature supports great results for tumor control but also for side effects and excellent...

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