Annual malignant transformation rate of oral leukoplakia remains consistent: A long-term follow-up study

Evren, Ilkay; Brouns, Elisabeth R.; Wils, Leon J.; Poell, Jos B.; Peeters, Carel F.W.; Brakenhoff, Ruud H.; Bloemena, Elisabeth; Visscher, J. G. A. M. de

doi:10.1016/j.oraloncology.2020.105014

Cited by 35 publications

(37 citation statements)

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“…Applying vulvar diagnostic criteria, differentiated dysplasia has been reported as a precursor to, or co-existing with, oral squamous cell carcinoma (Arsenic & Kurrer, 2013) but there is no difference in the risk of malignant transformation between it and a basaloid pattern of oral epithelial dysplasia (Arsenic & Kurrer, 2013;Wils et al, 2020) though the time to transformation was longer for the differentiated pattern (Wils et al, 2020). In the oral cavity, differentiated and basaloid patterns may reflect subsite, since differentiated dysplasia was more frequent in lower risk sites while basaloid dysplasia tended to affect lateral tongue and floor of mouth (Evren et al, 2020) where keratinisation is absent normally.…”

Section: Ifferentiated and Ba Saloid Dyspl A Siamentioning

confidence: 99%

“…This is primarily the result of not recognising or underscoring architectural/differentiated dysplasia, particularly in dysplasia with no basal atypia, as in clinically verrucous or histologically lichenoid lesions. This omission reduces the predictive value of oral epithelial dysplasia grading (Evren et al, 2020). Few studies have reassessed the features of biopsies that preceded carcinoma but had been reported as non-dysplastic, but one study showed that the underdiagnosed lesions were of architectural/differentiated type and diagnosed as hyperkeratosis or keratosis with a lichenoid reaction (Goodson et al, 2015).…”

Section: Ifferentiated and Ba Saloid Dyspl A Siamentioning

confidence: 99%

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Oral epithelial dysplasia: Recognition, grading and clinical significance

et al. 2021

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The concept of epithelial dysplasia was introduced into oral pathology over 60 years ago, following the recognition that some oral lesions had the potential to progress to oral cancer, now recognised as oral potentially malignant disorders (OPMDs). Attempts to grade oral dysplasia systematically were introduced into the literature in 1969, using photographic standards as reference (Smith et al., 1969) and internationally agreed classifications were formulated later

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Section: Ifferentiated and Ba Saloid Dyspl A Siamentioning

confidence: 99%

Section: Ifferentiated and Ba Saloid Dyspl A Siamentioning

confidence: 99%

Oral epithelial dysplasia: Recognition, grading and clinical significance

et al. 2021

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“…There are no evidence-based guidelines for surveillance of patients with a history of OL/OE and a number of research questions remain to be answered (Table 4). Given that the annual risk for cancer development remains consistent in retrospective OL cohorts followed over the long-term, irrespective of past treatment, suggests long-term surveillance is needed for patients with a history of OL/OE, perhaps life-long surveillance (Evren et al, 2020 Ho et al, 2013). In an analysis of a Medicare cohort in the United States (i.e., >65 years old), OSCC developing in patients with a previously imputed diagnosis of OL had lower stage disease compared to those without a diagnosis of OL, and a commensurate survival benefit (Yanik et al, 2015).…”

Section: Monitoring and Surveillancementioning

confidence: 99%

Management of oral potentially malignant disorders

Kerr

Lodi

2021

Oral Diseases

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Patients with oral potentially malignant disorders (OPMDs), including oral leukoplakia and erythroplakia, proliferative verrucous leukoplakia, oral submucous fibrosis, and oral lichen planus/lichenoid lesions, can be challenging to manage. A small proportion will undergo cancer development and determining a patient's cancer risk is key to making management decisions. Yet, our understanding of the natural history of OPMDs has not been fully elucidated, and a precision approach based on the integration of numerous predictive markers has not been validated by prospective studies. Evidence-based health promotion by clinicians and healthcare systems is not embraced universally. Medical and surgical interventions evaluated by rigorous research measuring important endpoints, such as cancer development, mortality, or survival, are difficult and expensive to run. Most of these studies employ non-ideal surrogate endpoints and have deep methodologic flaws. Diagnostic criteria for enrolling research subjects are not uniform, and patients with the highest risk for cancer development comprise small proportions of those enrolled. Few studies explore quality of life and patient preferences. It is time to rethink how we approach the management of these patients, across each OPMD, and considering the healthcare infrastructure and cost-effectiveness. Global networks with well-characterized patient populations with OPMDs and well-designed interventional trials using validated outcome measures are needed.

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“…Some of the precancerous changes are macroscopically visible [ 39 ]. Leukoplakia is the most common visible precancerous lesion that may precede invasive carcinomas.…”

Section: Field Cancerizationmentioning

confidence: 99%

“…The possibility of removing the precancerous field by surgical excision, laser surgery or cryotherapy seems tempting, but in that case visualization is key. Additionally, even then, many studies have shown that excision of visible lesions such as leukoplakia does not reduce the risk of malignant formation [ 39 , 55 ]. Leukoplakias recur or tumors develop elsewhere in the same or adjacent anatomical region.…”

Section: Field Cancerizationmentioning

confidence: 99%

Resection Margins in Head and Neck Cancer Surgery: An Update of Residual Disease and Field Cancerization

Pierik

Leemans

Brakenhoff

2021

Cancers

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Surgery is one of the mainstays of head and neck cancer treatment, and aims at radical resection of the tumor with 1 cm tumor-free margins to obtain locoregional control. Surgical margins are evaluated by histopathological examination of the resection specimen. It has been long an enigma that approximately 10–30% of surgically treated head and neck cancer patients develop locoregional recurrences even though the resection margins were microscopically tumor-free. However, the origins of these recurrences have been elucidated by a variety of molecular studies. Recurrences arise either from minimal residual disease, cancer cells in the surgical margins that escape detection by the pathologist when examining the specimen, or from precancerous mucosal changes that may remain unnoticed. Head and neck tumors develop in mucosal precursor changes that are sometimes visible but mostly not, fueling research into imaging modalities such as autofluorescence, to improve visualization. Mostly unnoticed, these precancerous changes may stay behind when the tumor is resected, and subsequent malignant progression will cause a local relapse. This led to a clinical trial of autofluorescence-guided surgery, of which the results were reported in 2020. This review focuses on the most recent literature of the improved diagnosis of the resection margins of surgically treated head and neck cancer patients, the pathobiological origin of recurrent disease, and relevant biomarkers to predict local relapse. Directions for further research will be discussed, including potential options for improved and personalized treatment, based on the most recently published data.

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Annual malignant transformation rate of oral leukoplakia remains consistent: A long-term follow-up study

Cited by 35 publications

References 50 publications

Oral epithelial dysplasia: Recognition, grading and clinical significance

Oral epithelial dysplasia: Recognition, grading and clinical significance

Management of oral potentially malignant disorders

Resection Margins in Head and Neck Cancer Surgery: An Update of Residual Disease and Field Cancerization

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