Preventive neck dissection for squamous cell carcinoma of the lower lip

Background: squamous cell carcinoma (SCC) is the most common histological type of malignancy affecting the lower lip. In cases of carcinoma at this site, the most significant diagnostic factor is the status of regional cervical metastases. Although surgery remains the treatment of choice, the use of prophylactic neck dissection in the absence of clinically detectable metastases remains a matter of ongoing debate. Aim: to assess the efficacy of prophylactic neck dissection in cases of clinically negative (cN0) lymph nodes in lower lip SCC Patients and Methods: this retrospective study included 85 patients diagnosed with lower lip SCC, classified as T1-4N0M0 according to the American Joint Committee on Cancer (AJCC). Of these, 51 patients underwent prophylactic neck dissection (study group) at a single institution between 2008 and 2023, while 34 patients did not undergo selective neck dissection (follow-up group) following primary tumor resection. Patients were evaluated with regard to the size of the primary tumor and the type of prophylactic neck dissection performed, based on risk and nodal status. Results: among the operated patients, regional metastases were identified in 14 (27.4%) cases. Prophylactic supraomohyoid (levels I–III) neck dissection was performed in 39 (76.5%) patients, with nodal metastases detected in 11 (28.2%) of them. Among patients who underwent anterolateral neck dissection (levels I–IV), this finding was observed in 3 (25.0%) cases. Conclusion: lower lip SCC is characterized by a relatively favorable prognosis; however, regional lymph node metastasis significantly worsens survival outcomes. The present results support the selective use of prophylactic neck dissection for T1–2N0 lower lip SCC in patients with high-risk patterns and its routine performance in all cases of stage T3–4N0M0 disease to prevent regional metastatic spread. Taking risk factors into account, we advocate for supraomohyoid (levels I–III) neck dissection in cN0 patients with high-risk lower lip carcinoma. KEYWORDS: lower lip tumors, squamous cell carcinoma, neck dissection. FOR CITATION: Rustamzade M.A., Amiraliev N.M. Preventive neck dissection for squamous cell carcinoma of the lower lip. Russian Medical Inquiry. 2025;9(7):382–386 (in Russ.). DOI: 10.32364/2587-6821-2025-9-7-2