Comparison of cryogun or cotton-swab cryotherapy for oral leukoplakia

Objectives: Oral leukoplakia (OL) is a common oral premalignant lesion. Our previous study showed that cotton-swab cryotherapy (CSC) is an alternative treatment modality for OL lesions. This study was designed to test whether the liquid nitrogen spray with a cryogun (cryogun cryotherapy, CC) was also an effective treatment modality for OL lesions and whether the CC is a more effective treatment modality than the CSC. Methods: This study used the CC to treat 60 OL lesions in 54 patients. The clinical outcomes of OL lesions treated with either the CC or CSC were compared. Results: Complete regression (CR) was achieved in all 60 OL lesions after an average of 3.1 ± 1.3 treatments of CC. We found that 60 OL lesions treated with CC needed significantly fewer treatments to achieve CR than 60 previously reported OL lesions treated with CSC (mean, 6.3 ± 3.8 treatments). The number of CC treatments required to achieve CR was significantly fewer for OL lesions on oral mucosal sites other than the tongue, those < 2 cm2, those with epithelial dysplasia, and those with a surface keratin thickness of < 55 μm. However, only the surface keratin thickness (p = 0.005) was an independent factor influencing the number of CC treatments required to achieve CR by multivariate Cox proportional hazard regression analyses. Conclusions: For treatment of OL lesions, the CC is a more effective treatment modality than the CSC.