IADR Abstract Archives
Factors Associated With Malignant Transformation of Oral Leukoplakia and Lichenoid Lesions
Objectives: To identify clinicopathologic factors associated with the malignant transformation of oral leukoplakia and oral lichenoid lesions (OPMDs) in the Hong Kong population.
Methods: A retrospective review of 716 patients with clinical diagnosis of oral leukoplakia, oral lichen planus, or oral lichenoid lesions that underwent incision or excisional biopsy for confirmatory diagnosis was undertaken to investigate potential factors influencing the transformation to oral squamous cell carcinoma. Kaplan-Meier estimates and Cox proportional hazard analysis were used to explore the factors associated with malignant transformation.
Results: Overall, 10.6% of the patients developed squamous cell carcinoma, with a mean duration of transformation of 90.40 months. A previous history of non-head and neck cancer [95%CI(1.039-7.369), P=0.042] or hematologic malignancies [95% CI(1.068-9.479), P=0.038] increased the risk of malignant transformation from OPMDs by 2.277- and 3.182-fold respectively. Patients presenting with OPMD lesions at the tongue or floor of mouth had a higher potential of malignant transformation [HR 2.592, 95% CI(0.176-0.846), P=0.017]. Induration was also associated with a 4.465-fold increased risk to malignancy transformation [95% CI(2.148-9.282), P<0.0001]. Patients treated with surgical excision and did not experience any recurrence had a lower risk of malignant transformation [HR= 0.362, 95% CI (0.149-0.881), P=0.025]. This risk was also statistically significant especially for those presenting with mild [HR= 4.519, 95% CI(2.015-10.138), P<0.0001], moderate [HR= 7.433, 95% CI (3.191-17.314), P<0.0001], or severe [HR= 7.634, 95% CI(2.108-27.646), P=0.002] dysplasia at diagnosis. A significant association of malignant transformation remained for those presenting with moderate [HR= 5.620, 95% CI(2.382-13.263), P<0.0001], or severe [HR= 5.742, 95% CI(2.598-12.691), P<0.0001] dysplasia upon follow up.
Conclusions: Long term follow-up and clinicopathologic examination remain crucial steps as the results showed that clinicopathologic factors such as previous cancer history, lesions at the tongue or floor of mouth, induration, dysplasia and recurrence post treatment are associated with malignant transformation.
Methods: A retrospective review of 716 patients with clinical diagnosis of oral leukoplakia, oral lichen planus, or oral lichenoid lesions that underwent incision or excisional biopsy for confirmatory diagnosis was undertaken to investigate potential factors influencing the transformation to oral squamous cell carcinoma. Kaplan-Meier estimates and Cox proportional hazard analysis were used to explore the factors associated with malignant transformation.
Results: Overall, 10.6% of the patients developed squamous cell carcinoma, with a mean duration of transformation of 90.40 months. A previous history of non-head and neck cancer [95%CI(1.039-7.369), P=0.042] or hematologic malignancies [95% CI(1.068-9.479), P=0.038] increased the risk of malignant transformation from OPMDs by 2.277- and 3.182-fold respectively. Patients presenting with OPMD lesions at the tongue or floor of mouth had a higher potential of malignant transformation [HR 2.592, 95% CI(0.176-0.846), P=0.017]. Induration was also associated with a 4.465-fold increased risk to malignancy transformation [95% CI(2.148-9.282), P<0.0001]. Patients treated with surgical excision and did not experience any recurrence had a lower risk of malignant transformation [HR= 0.362, 95% CI (0.149-0.881), P=0.025]. This risk was also statistically significant especially for those presenting with mild [HR= 4.519, 95% CI(2.015-10.138), P<0.0001], moderate [HR= 7.433, 95% CI (3.191-17.314), P<0.0001], or severe [HR= 7.634, 95% CI(2.108-27.646), P=0.002] dysplasia at diagnosis. A significant association of malignant transformation remained for those presenting with moderate [HR= 5.620, 95% CI(2.382-13.263), P<0.0001], or severe [HR= 5.742, 95% CI(2.598-12.691), P<0.0001] dysplasia upon follow up.
Conclusions: Long term follow-up and clinicopathologic examination remain crucial steps as the results showed that clinicopathologic factors such as previous cancer history, lesions at the tongue or floor of mouth, induration, dysplasia and recurrence post treatment are associated with malignant transformation.