Objectives: 1. To assess incidence and mean time of malignant transformation of oral precancerous lesions. 2. To assess the importance of potential risk factors for malignant transformation.
Methods: Following ethical approval, between 1997 and 2005, 96 patients (58 male, 38 female) with a mean age of 59 years (27- 91 years) attending the Maxillofacial Oncology/Dysplasia clinic at Newcastle General Hospital were recruited into the study. A total of 132 oral precancerous lesions were identified. All patients underwent a standardised managed protocol comprising risk factor identification (smoking status, alcohol intake and nutritional status), interventional laser surgery, excision of lesions and assessment of degree of dysplasia at presentation. Regular three monthly co-ordinated post-operative follow up was subsequently carried out. Statistical comparisons were carried out using Fischer Exact Test and Chi square tests.
Results: Seven patients (7.3%) developed squamous cell carcinoma (SCC) in the study. Mean time of SCC identification was 58 months (range 12-96 months). Three of these were non smokers and 4 smokers. Non smokers developed significantly more SCC lesions than smokers (p=0.022). There was no significant relationship between gender, age of patients at presentation, degree of dysplasia, alcohol intake or nutritional status and development of SCC.
Conclusion: In the North East of England, rate of malignant transformation of oral precancers is similar to previously published data. Smokers with dysplastic lesions are less likely than non smokers to develop oral squamous cell carcinoma. Malignant transformation appears to be unaffected by age, gender, alcohol intake, nutritional status and degree of dysplasia at presentation.