Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Vermilion vs Cutaneous Location in cSCC of the Lip

JAMA Dermatology; ePub 2018 May 2; Wang, et al

The risk of nodal metastasis is 5-fold greater for cutaneous squamous cell carcinomas (cSCCs) on the vermilion lip compared with those on the cutaneous lip, according to a recent study. Furthermore, SCCs of the cutaneous lip have a nodal metastasis risk similar to cSCCs in general (1.5%). Researchers conducted a retrospective cohort study of 303 patients with 310 primary cSCCs of the lip (138 cutaneous, 172 vermilion) diagnosed between 2000 and 2015 at 2 academic tertiary care centers in Boston, MA. They found:

  • Of the total study participants with SCCs of the lip, 153 (50.5%) were men, and 150 (49.5%) were women; median age at diagnosis was 68 years (range, 27-93 years).
  • Outcomes were as follows for vermilion vs cutaneous locations: local recurrence, 6.4% (11 of 172) vs 2.9% (4 of 138); nodal metastasis, 7.6% (13 of 172) vs 1.5% (2 of 138); distant metastasis, 0.6% (1 of 172) vs 0.7% (1 of 138); disease-specific death, 3.5% (6 of 172) vs 2.9% (4 of 138); and all-cause death, 26.7% (46 of 172) vs 29.0% (40 of 138).
  • The difference was statistically significant for nodal metastasis.


Wang DM, Kraft S, Rohani P, et al. Association of nodal metastasis and mortality with vermilion vs cutaneous lip location in cutaneous squamous cell carcinoma of the lip. [Published online ahead of print May 2, 2018]. JAMA Dermatology. doi:10.1001/jamadermatol.2018.0792.

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