Malignant transformation rate of oral leukoplakia in the past 20 years: A systematic review and meta‐analysis

Abstract

BackgroundThis meta‐analysis aimed to assess the rate of malignant transformation (MT) of oral leukoplakia (OL) and to study potential risk factors for the MT of OL into oral squamous cell carcinoma (OSCC).MethodWe performed a bibliographic search on nine electronic databases, including PubMed, MEDLINE, and Wanfang Data, for data on the MT rate of OL. Possible risk factors were calculated using Comprehensive Meta‐Analysis and Open Meta [Analyst] software.ResultsThe pooled proportion of OL MT for the total population described in the 26 selected studies was 7.20% (95% confidence interval: 5.40–9.10%). Nonhomogeneous type lesions, higher grades of dysplasia, the location of the lesion (tongue and multifocal), and female sex had significant effects on the MT of OL.ConclusionOL tended to develop into OSCC (7.2%), and those with significant MT risk factors should be subjected to regular follow‐up and observation. However, we require large‐scale prospective studies to validate these results, together with unified clinicopathological diagnostic criteria, standardized risk factor recording/assessment methods, and long‐term follow‐up guidelines.

Oral verruciform xanthomas mimicking potentially malignant disorders

“…Oral verruciform xanthoma can easily be misinterpreted as a precursor of the highest prevalent potentially malignant lesion ( 8 ) e.g., leukoplakia. It is well-established that leukoplakia has a questionable malignant risk, and its accurate diagnosis requires ruling out other oral white lesions with specific etiology ( 8 ).…”

“…Oral verruciform xanthoma can easily be misinterpreted as a precursor of the highest prevalent potentially malignant lesion ( 8 ) e.g., leukoplakia. It is well-established that leukoplakia has a questionable malignant risk, and its accurate diagnosis requires ruling out other oral white lesions with specific etiology ( 8 ). Consequently, the histopathological analysis is crucial in white lesions for identification of dysplastic changes in the squamous epithelium that increase the risk of oral cancer development.…”

Laser therapy decreases oral leukoplakia recurrence and boosts patient comfort: a network meta-analysis and systematic review

“…Traditional meta-analysis integrates effect sizes from trials of the same intervention, providing strong and credible evidence for the informed selection of appropriate interventions for a specific disease [ 12 ]. Previous meta-analyses have primarily focused on the effect of laser and surgical excision on the malignant process of OLK [ 13 ]. However, the factors affecting OLK carcinogenesis are complex, including pathological staging, duration of disease, and the patient’s reasons.…”

Predictors of malignant transformation in oral leukoplakia and proliferative verrucous leukoplakia: An observational prospective study including the DNA ploidy status

“…Localized oral leukoplakia (OL) is one of the most common OPMDs, characterized by the presence of “white plaque of questionable risk having excluded (other) known diseases or disorders that carry no increased risk for cancer.” 2 On the other hand, proliferative verrucous leukoplakia (PVL) is a rare condition with multiple, multifocal, simultaneous leukoplakias that frequently cover wide areas of the oral mucosa 3 . PVL is considered a distinct form of multifocal OL; these conditions have remarkably different MT rates (ranging from 49.5% to 53.2% and from 9.5% to 16.4%, respectively), 1,4–6 with PVL having the highest proportion of oral cavity cancer development compared with other OPMDs 1,7 . Patients with OL present either single flat or variable multifocal lesions, 8,9 and a correct interpretation of clinical features of multifocal oral leucoplakias is mandatory for the correct identification of PVL.…”