Follow-up of Oral Leukoplakia After Carbon Dioxide Laser Surgery

Abstract

We evaluate the 3-year result of 145 oral leukoplakias operated on by outpatient carbon dioxide laser surgery at the Istituto Nazionale Tumori, Milan, Italy. The surgical technique that was used consisted of excision in 140 patients and vaporization in 5 patients. Cancer was found in 14 out of 140 patients who underwent excision (10%). In the analysis of the disease-free survival rate and of the unfavorable pattern of events, only 131 patients with benign postoperative histologic diagnosis were considered. Fifty-eight patients developed unfavorable events. The probabilities of remaining free of disease or of developing local relapses or new lesions at 3-year survival was 0.57, 0.27, and 0.19, respectively. Two patients had oral carcinomas after the operation. Forty patients modified their alcohol or tobacco habits or their teeth and/or prosthesis. Moreover, only two patients modified these factors before the unfavorable events occurred.

Randomized trial of fenretinide (4‐HPR) to prevent recurrences, new localizations and carcinomas in patients operated on for oral leukoplakia: Long‐term results

“…2 The original trial was designed to detect a 5% difference between the 2 arms in the incidence of oral cavity carcinomas over 4 years and a 15% difference in the incidence of recurrences or new leukoplakias over 3 years (a ¼ 5%, b ¼ 20%, 2-tailed test), assuming proportional hazards. 26 The sample size required was 300 patients.…”

“…2 However, we assessed the overall cancer incidence in the previous series irrespective of whether the cancer manifested as a first or second/subsequent event after leukoplakia treatment; in the present study, we considered only first-event cancers. Indeed, proportionately more cancers developed in the present than the earlier series, but the observation period was longer (>5 vs. 3 years).…”

“…Oral leukoplakia is a precancerous mucosal condition with a probability of transforming into oral carcinoma estimated at about 10% over 20 years. [2][3][4][5][6] Patients whose leukoplakias are removed surgically frequently develop local relapses or new leukoplakias; 2 they are also at increased risk of developing oral carcinoma even when the leukoplakia is hyperkeratinotic and not dysplastic. 2 Such patients are excellent candidates for trials on chemopreventive agents, 3,4,7 particularly since oral cavity accessibility allows convenient histologic and photographic evaluation of intervention efficacy.…”

Surgical treatment of patients with oral leukoplakia

“…Наи-более часто патологические участки, пораженные лейко-плакией, иссекают с помощью хирургического скальпе-ля, криовоздействия, излучения CO 2 -лазера и др. [7,9,21,41,83].…”

Leucoplasia oral: tratamento cirúrgico com laser de CO2 e de diodo e análise por imuno-histoquímica da expressão de proteínas relacionadas à carcinogênese (p53, COX-2 e EGFR)

“…Na literatura, as taxas de recorrência compreendem entre 10% e 57% (Chu et al, 1988;Chiesa et al, 1990;Roodenburg et al, 1991;Schepman et al, 1998;Schoelch et al, 1999;Saito et al, 2001;Wylie, 2002;Ishii et al, 2003;Chandu;Smith, 2005;van der Hem et al, 2005;Vivek et al, 2008;. Essa variação pode ser atribuída aos tipos de lasers utilizados, parâmetros de irradiação, critérios de inclusão, período de acompanhamento e etnia da população estudada Porter, 2008).…”