Oral precursor lesions and malignant transformation – who, where, what, and when?

Goodson, M.L.; Sloan, Philip; Robinson, Max; Cocks, Kim; Thomson, Peter

doi:10.1016/j.bjoms.2015.08.268

Cited by 71 publications

(63 citation statements)

References 19 publications

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“…Interestingly, lichenoid inflammation alone may contribute to MT. Goodson et al reviewed 1248 OSCCs and found that only 5.8% arose from documented OPMDs (similar rate of 6% in Cowan et al) and whilst 43% were classified as dysplasia or carcinoma in situ, 33% were classified as hyperkeratosis with lichenoid inflammation. Histological evidence of inflammation in cases of dysplasia or OSCC are relatively common, with rates of 20%‐30% of lesions displaying lichenoid features .…”

Section: Discussionmentioning

confidence: 87%

Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates

Shearston

Fateh

Tai

et al. 2019

J Oral Pathology Medicine

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Objectives Oral potentially malignant disorders (OPMD) include a variety of mucosal lesions such as oral lichen planus (OLP), oral lichenoid lesions (OLL) and oral lichenoid dysplasia (OLD). Their rate of malignant transformation ranges from 0% to 34% and is dependent on OPMD type, lesion site and a range of risk factors. This study seeks to determine the proportion of oral lichenoid conditions that transform into oral squamous cell carcinoma (OSCC) in an Australian population. Methods The study is a retrospective audit of patients from a private oral medicine clinic, diagnosed with OLP, OLL or OLD using clinical and histopathological data between 2006 and 2014. Patients were cross‐matched with Cancer Registry data for OSCC, and the rate and time to malignant transformation determined. Results OLP and OLL patients displayed a low risk of malignant transformation; 0.49% (1/206) for OLP and 0% (0/31) for OLL. In contrast, OLD patients, all of whom presented clinically as OLP, were at much higher risk with 6.81% (3/44) developing OSCC over an average time of 4.6 years (±2.4 SD). Rates of smoking and alcohol consumption were no higher in OLD patients compared to others. Conclusions Compared with other oral lichenoid conditions, OLD lesions are at a particularly high risk of malignant transformation and should be managed based on the presence of dysplasia and not the lichenoid inflammatory infiltrate. OLP demonstrates a relatively low rate of malignant transformation. Diagnostic histopathology is important for discriminating OLP from OLD.

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Section: Discussionmentioning

confidence: 87%

Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates

Shearston

Fateh

Tai

et al. 2019

J Oral Pathology Medicine

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“…Warnakulasuriya & Ariyawardana reviewed 24 observational studies of oral leukoplakia and identified advanced age, females, lesion greater than 200 mm 2 in size, non‐homogenous clinical appearance and severe dysplasia as high risk. Other authors, however, have not found clinical or pathological observations to correlate reliably with malignant transformation, with currently available biomarkers of little practical use …”

Section: Discussionmentioning

confidence: 99%

Profiling cancer risk in oral potentially malignant disorders—A patient cohort study

Thomson

Goodson

Smith

2017

J Oral Pathology Medicine

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“…46,47 Further, while expert opinion suggests screening for these lesions in the general population using standard visual and tactile exam (VTE) 44 followed by surgical biopsy, this approach is associated with potential morbidity. 48 Moreover, both a meta-analysis and a subsequent, large cohort study questioned the clinical utility of VTE and surgical biopsy 49,50 Adjunctive visualization methods such as VELscope and Vizilite have shown good sensitivity but poor specificity. 49 While results with oral cytology in those with visible OPMD have been encouraging (e.g., to triage who requires biopsy), appropriate studies in the general clinic population are required, and there is a paucity of relevant data in HIV-infected individuals.…”

Section: Site-specific Screening Approachmentioning

confidence: 99%

Screening for Cancer in Persons Living with HIV Infection

et al. 2016

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Survival with human immunodeficiency virus (HIV) infection has greatly improved due to effective antiretroviral therapy (ART). As infectious complications have declined, malignancy now accounts for over one-third of deaths among people living with HIV (PLWH). Based on practices in the general population, cancer screening of PLWH can decrease both morbidity and mortality. In this article, we review and consider directed approaches for colorectal, breast, cervical and lung cancer screening. Furthermore, routine physical examinations may detect lymphomas and skin, anal and oral cancers. Comprehensive cancer prevention in PLWH should also include ART adherence, vaccination against oncogenic viruses, treatment of hepatitis viruses and smoking cessation. Cancer screening for PLWH warrants further research on safety and efficacy as well as targeted efforts to increase adherence.

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Oral precursor lesions and malignant transformation – who, where, what, and when?

Cited by 71 publications

References 19 publications

Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates

Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates

Profiling cancer risk in oral potentially malignant disorders—A patient cohort study

Screening for Cancer in Persons Living with HIV Infection

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