Oral squamous cell carcinoma associated with proliferative verrucous leukoplakia compared with conventional squamous cell carcinoma—a clinical, histologic and immunohistochemical study

Proliferative leukoplakia: Proposed new clinical diagnostic criteria

“…A recent study from Akrish, Ben‐Izhak, Sabo, and Rachmiel () has shown that SCC arising from PVL has different clinical behavior and epigenetic/genetic characteristics compared to SCC that did not arise from PVL Specifically, patients with PVL who underwent malignant transformation displayed early‐stage SCC, with smaller tumor size, no lymph node metastasis, and no distant metastasis, and experienced significantly improved 4‐year survival compared to non‐PVL‐associated SCC (100.0% vs. 56.9%). It is likely that frequent follow‐up visits and surveillance contributed to early detection and, as such, early‐stage lesions resulting in improved prognosis.…”

Oral potentially malignant disorders: risk of progression to malignancy

“…81,[84][85][86] Gingival and palatal lesions are also the most likely to undergo malignant transformation. 84,87,88 The etiopathogenesis is poorly understood, and there appears to be no correlation with alcohol consumption, tobacco chewing, smoking, or HPV infection. 81,84,85 The overall mortality rate is also somewhat unclear, with some studies reporting a 5-year survival rate of 60%, whereas others have suggested it to be less aggressive.…”

Cancer‐associated fibroblasts are an infrequent finding in the microenvironment of proliferative verrucous leukoplakia‐associated squamous cell carcinoma

“…The inclusion criteria were patients treated with tumor resection and confirmation of lymph node status by way of a neck dissection or PET scan and available for immunohistochemical analysis. This represents an expansion and update of a previously existing cohort including patients with the same criteria from 1990 through 2012 and includes follow‐up data as of July 1, 2016. The study was approved by the IRB of Rambam Medical Center.…”

“…Initially, the lesions appear innocuous and are indistinguishable clinically from leukoplakia. The second developmental stage is clinically exophytic lesions, diagnosed microscopically as verrucous hyperplasia and/or verrucous carcinoma . In the later stages, over 74% of patients with PVL will experience multiple and multifocal incidences of OSCCA, particularly on the gingiva, palate, and buccal mucosa .…”

“…In a previous study, we compared the clinicopathological features of OSCCA arising in PVL patients (p‐scca) with conventional buccal mucosa, gingival, and palatal OSCCA (c‐scca) and discovered that p‐scca patients seem to present with more favorable prognostic features and longer duration of illness (DOI). Based on the results of this earlier study, we suggested that p‐scca should be considered a separate clinical entity .…”