Journal
INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY
Volume 50, Issue 11, Pages 1422-1428Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.ijom.2021.01.012
Keywords
mouth neoplasms; carcinoma; squamous cell; leukoplakia; oral
Categories
Funding
- Lion's Cancer foundation West
- Assar Gabrielssons Foundation
- Department of Research and Development, NU Hospital Group
- Swedish Dental society
- Gothenburg Dental society
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Non-homogeneous oral leukoplakia, leukoplakia with dysplasia, and leukoplakia localized to the tongue have higher rates of malignant transformation.
It is clinically challenging to identify oral leukoplakias that have a high risk of undergoing malignant transformation. The aim of this retrospective study was to elucidate the associations between malignant transformation of oral leukoplakias and various clinicopathologic factors. Patients with a diagnosis of clinical oral leukoplakia, verified through histopathologic examination and with access to digital images of the lesion, were retrospectively included for the period 2003-2013. Using the clinical images, all lesions were re-evaluated regarding diagnosis and clinical subtype. Of the 234 included patients, with a median follow-up of 9 years, 27 (11.5%) developed oral squamous cell carcinoma. Among the clinicopathologic factors investigated, non-homogeneous oral leukoplakia (OL), OL with dysplasia, and OL localized to the tongue showed statistically significant increased rates of malignant transformation in the multivariate Cox regression analysis. Non-homogeneous OL showed a 15.2-times higher transformation rate than homogenous OL (P < 0.001). Dysplastic leukoplakias developed into carcinomas 2.4-times more often than did nondysplastic leukoplakias (P = 0.048). OL located on the tongue showed a 2.8-times higher malignant transformation rate than OLs at other oral locations (P = 0.018), when other locations were combined into one group. Non-homogeneous OL, OL with dysplasia, and OL localized to the tongue have higher transformation rates.
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