{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:00:56Z","timestamp":1790686856610,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare oncologic outcomes among vermillion, nonvermillion cutaneous, and mucosal lip squamous cell carcinoma (SCCa), with a focus on the prognostic significance of vermillion SCCa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary academic medical center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included all patients diagnosed with SCCa of the mucosal, nonvermillion, or vermillion lip between 2013 and 2024 at our tertiary institution. Subsites were compared in terms of categorical variables using Fisher's exact or\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      tests, and continuous variables with Kruskal\u2010Wallis test. Covariate\u2010adjusted Cox proportional hazards regression was used to estimate the relative hazard of mortality by subsite.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and ninety\u2010three patients were identified. Subsites included 44.0% vermillion, 38.9% nonvermillion, and 17.1% mucosal lip. Mucosal tumors were more often stage II or higher (58.0%) than nonvermillion (8.7%) or vermillion (22.5%). In pairwise comparisons, nodal metastasis rates were significantly higher for mucosal (24%) and vermillion (14%) than nonvermillion (0) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Nonvermillion and vermillion SCCa showed significant lower hazard than mucosal SCCa (HR 0.32, 95% CI 0.16\u20100.66,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.002, and HR 0.31, 95% CI 0.15\u20100.63,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.001, respectively), though this difference no longer persisted after covariate\u2010adjustment. Recurrence rates did not differ following treatment (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.291). Mucosal SCCa had worse disease\u2010specific mortality (20.5%) than vermillion (2.6%) or non\u2010vermillion SCCa (0) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Vermillion and mucosal lip SCCa show higher nodal involvement than nonvermillion SCCa. Mucosal SCCa demonstrates worse survival in unadjusted analysis, prior to covariate\u2010adjustment. Larger studies are needed to validate the adjusted association and clarify long\u2010term prognostic implications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70469","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T12:40:05Z","timestamp":1790685605000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nodal Metastasis in Vermillion, Cutaneous, and Mucosal Lip Squamous Cell Carcinoma: Examining Vermillion Invasion"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5421-718X","authenticated-orcid":false,"given":"James R.","family":"Gardner","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences (UAMS)  Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2858-1225","authenticated-orcid":false,"given":"Kenny","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences (UAMS)  Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Herberger","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences (UAMS)  Arkansas USA"},{"name":"College of Medicine at the University of Arkansas for Medical Sciences  Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Zaniletti","sequence":"additional","affiliation":[{"name":"IZ statistics LLC Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Eckard","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences (UAMS)  Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Phillips\u2010Cosio","sequence":"additional","affiliation":[{"name":"College of Medicine at the University of Arkansas for Medical Sciences  Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carissa","family":"Saadi","sequence":"additional","affiliation":[{"name":"College of Medicine at the University of Arkansas for Medical Sciences  Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences (UAMS)  Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Vural","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences (UAMS)  Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jumin","family":"Sunde","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Arkansas for Medical Sciences (UAMS)  Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Bailey's Head and Neck Surgery: Otolaryngology","author":"Gray ST","year":"2022"},{"key":"e_1_2_8_3_1","unstructured":"National Comprehensive Cancer Network. 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