Nodal Metastasis in Vermillion, Cutaneous, and Mucosal Lip Squamous Cell Carcinoma: Examining AJCC 8 Staging

Sunday, October 12, 2025

8:18 AM - 8:24 AM EDT

Location: 127

Disclosure(s):

Peter DA Eckard, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

James R. Gardner, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Squamous cell carcinoma (SCC) of the vermilion lip is staged with cutaneous SCC, distinct from oral cavity staging of mucosal lip SCC. There is limited data on nodal metastasis of vermillion SCC compared to non-vermillion cutaneous SCC or mucosal lip SCC. This study aims to compare outcomes of vermillion lip SCC (vcSCC) to non-vermillion lip cutaneous SCC (nvcSCC) and mucosal lip SCC (mSCC).

Methods: Retrospective cohort study of all patients with mucosal or cutaneous lip SCC from 2013-2024 at a tertiary care institution. Patient demographics, comorbidities, oncologic history and treatment, subsite location (vcSCC, nvcSCC, mSCC), and oncologic outcomes were analyzed using Fischer’s exact test or ANOVA where appropriate.

Results: There were 294 patients identified. The lesion was a new primary in 91.8% of cases. The anatomic subsite locations consisted of 44.2% vcSCC, 38.4% nvcSCC, and 17.0% mSCC. There were no significant differences in demographics or medical comorbidities. mSCC were typically higher stage (stage 2 or higher (73.2%) vs nvcSCC (34.8%) or vcSCC (42.9%)). nvcSCC were less likely to have lymph node involvement compared to both mSCC (p=0.0001) and vcSCC (p=0.0001), but there was not a significant difference between vcSCC and mSCC (p=0.33). There was no difference in recurrence between tumor subsites (p=0.63).

Conclusions: Vermillion lip SCC is staged according to cutaneous staging guidelines. However, vermillion and mucosal lip SCC are more likely to have nodal metastasis than nvcSCC. The higher rate of nodal metastasis in vcSCC suggests it may have metastatic characteristics more similar to mSCC.

Presenting Author(s)

JG

James R. Gardner, MD

Resident Physician
University of Arkansas for Medical Sciences
Little Rock, AR, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Peter DA Eckard, MD

Resident
University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
RP

Robert D. Phillips-Cosio, BA

Medical Student
University of Arkansas for Medical Sciences
Little Rock, AR, United States

Disclosure information not submitted.
Lindsey S. Herberger, BA

Medical Student
University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States

Disclosure information not submitted.
CS

Carissa C. Saadi, BS

Medical student
University of Arkansas for Medical Sciences
Little Rock, Arkansas, United States

Disclosure information not submitted.
Mauricio A. Moreno, MD

Professor
University of Arkansas for Medical Sciences
Little Rock, AR, United States

Disclosure information not submitted.
EV

Emre A. Vural, MD

Professor
University of Arkansas for Medical Sciences
Little Rock, AR, United States

Disclosure information not submitted.

Senior Author(s)

JS

Jumin Sunde, MD

University of Arkansas for Medical Sciences, USA

Disclosure information not submitted.