Oral tongue leukoplakia: analysis of clinicopathological characteristics, treatment outcomes, and factors related to recurrence and malignant transformation

Abstract

Objectives The tongue is identified as a high-risk site for oral leukoplakia and malignant transformation. The purpose of this study is to investigate the clinicopathological characteristics and treatment outcomes of tongue leukoplakia and assess the factors related to recurrence and malignant transformation. Materials and methods One hundred and forty-four patients who received carbon dioxide laser surgery for tongue leukoplakia from 2002 to 2019 were analyzed statistically. Results The follow-up period was 54.90 ± 54.41 months. Thirty patients showed postoperative recurrence (20.83%), and 12 patients developed malignant transformation (8.33%). The annual transformation rate was 2.28%. Univariate analysis showed that a history of head and neck cancer, size of lesion area, clinical appearance, and pathology were significant factors for both recurrence and malignant transformation. In the multivariate logistic regression, a history of head and neck cancer and size of lesion area were independent prognostic factors for recurrence, and a history of head and neck cancer was the only independent factor for postoperative malignant change. Conclusions Clinicians should adopt more aggressive strategies for tongue leukoplakia patients with a history of head and neck cancer. Clinical relevance These results may help clinicians gain a better understanding of oral tongue leukoplakia.

A Retrospective Cohort Study of Oral Leukoplakia in Female Patients—Analysis of Risk Factors Related to Treatment Outcomes

“…In this cohort, the overall cumulative malignant transformation rate and ATR of OL in female patients were 8.22% and 2.08%; while those in male patient were 6.31% and 1.76%, respectively. The ATRs in both genders were similar to the previous reports of OL whose ATRs ranged from 1.08% to 4.90% [15,16,58,60,[64][65][66][67][68][69]. In the Kaplan-Meier survival analysis and log-rank tests, postoperative recurrence was the factor related to malignant change of OL (Hazard ratio: 11.92, CI 95% 2.07-68.67, p = 0.02, Table 4) after laser surgery.…”

“…The mean area of the OL with postoperative recurrence (4.81 ± 4.18 cm 2 ) was significantly larger than that of non-recurrent lesions (1.79 ± 2.40 cm 2 ). Not only in the present study, size of area was also a significant factor associated with postoperative recurrence in the studies of oral tongue leukoplakia [58], elderly patients with OL [59], and patients with oral erythroplakia [21]. In addition to being a critical factor related to recurrence, the area of OL was reported to be a risk factor affiliated with malignant change of OL in several studies [11,60,61].…”

“…In the Cox proportional regression analysis model, postoperative recurrence was not significant but the trend towards malignant transformation of OL existed (p = 0.07, Table 4). Recurrence, defined as regeneration of whitish patch on the same site after surgical excision, implies treatment failure and was found to be a risk factor for malignant transformation of OL in the previous studies [23,58,70]. Usually, the extent of excision of the OL lesion was made based on the judgment from the surgeon's naked eyes on the region of the lesion, the outline of excision was set about 3 mm outside the clinical margin of the targeted OL in order to achieve an adequate and total extirpation of OL [22,23].…”

The use of the phrase “data not shown” in dental research

“…Some authors seemed to use the phrase just to indicate that certain numbers were not represented in the tables or figures but while providing data or results in the same sentence with words; for example: “The ratio of patients showing a history of head and neck cancer (19/47 vs. 14/97, P = 0.0007, data not shown)…” [ 21 ].…”

Oral tongue squamous cell carcinomas in young patients according to their smoking status: a GETTEC study

“…However, NS, especially non-smoking women, have been consistently reported to be at greater risk of malignant transformation of leukoplakia compared to smoking women [17,31]. In addition to tobacco or smokeless tobacco use, other reported risk factors for malignant transformation of oral leukoplakia included large size, non-homogeneous clinical aspect female sex, old age, location on the tongue or floor of mouth, and high-grade dysplasia [17,32]. We also found that patients with leukoplakia had a significantly improved survival compared to patients with no history of leukoplakia.…”