Background and Objectives: An increasing incidence of non-melanoma skin cancer (NMSC) is noted, as well as an increasing cost of the treatment, with NMSC becoming a public health problem. We aimed to investigate the prevalence and treatment costs of surgically treated NMSC from the Oral and Maxillofacial Surgery Department of Cluj-Napoca County Hospital. Materials and Methods: We retrospectively analyzed the clinical data and the charge data of hospitalization from the informatic system of Cluj-Napoca County Hospital. All patients benefited from standard surgical excision with the reconstruction of the post-excisional defect. A statistical analysis of the costs related to the patients’ features, period and conditions of hospitalization, materials, medication, and paraclinical investigations was performed. Results: Between 2015 and 2019, 133 patients with NMSC were addressed to our department, with basal cell carcinoma (BCC) being four-fold higher than squamous cell carcinoma (SCC). Most NMSC cases were diagnosed in stage I or II, and they benefited from local reconstruction. The treatment costs progressively increased in the last five years, reaching a total cost of EUR ~13.000 in 2019. The treatment cost per episode was higher for SCC compared to BCC, while the total cost of treatment in 5 years was higher for BCC. Low income, immunosuppression, comorbidities, flap reconstruction option, long-lasting surgery, and prolonged hospitalization were associated with an increased cost of the treatment. Conclusion: The prevalence and treatment cost of surgically treated NMSC of the head and neck region increased in the last five years, with high-cost drivers being related to patients and treatment options.

Background: Early-stage squamous cell carcinoma of the lip and oral cavity may behave aggressively despite clinically negative cervical lymph nodes. Tumor budding (TB) and worst pattern of invasion (WPOI) have been proposed as histopathological markers of invasive behavior, but their prognostic value in cT1–2N0M0 disease remains uncertain. Methods: This PRISMA 2020 systematic review included studies published as eligible full-text journal articles up to 25 April 2026 and was informed by REMARK and guidance for systematic reviews of prognostic factor studies. PubMed and Scopus were searched as bibliographic databases, supplemented by ScienceDirect, Semantic Scholar, and backward and forward citation searching. Eligible studies assessed TB and/or WPOI in resection specimens from surgically treated cT1–2N0M0 lip/oral cavity squamous cell carcinoma and reported nodal, recurrence, or eligible survival outcomes. Risk of bias was evaluated using the Quality In Prognosis Studies (QUIPS) tool. Results: Thirty-eight reports met eligibility criteria; linked or partially overlapping cohorts were treated as related evidence to avoid double counting. Higher-risk WPOI and high-grade TB were associated with cervical nodal disease, locoregional recurrence, and adverse survival across multiple reports, although adjusted effects varied. Eligible survival outcomes included disease-free survival, recurrence-free survival, disease-specific/cancer-specific survival, and overall survival; progression-free survival was excluded. Conclusions: TB and WPOI may provide complementary postoperative prognostic information in clinically node-negative early-stage lip and oral cavity squamous cell carcinoma. Heterogeneity in definitions, thresholds, cervical management, endpoints, and statistical adjustment precluded a single pooled estimate and limits immediate clinical implementation. Neither marker should currently be used as an isolated determinant of treatment decisions.