The natural history of oral epithelial dysplasia: perspective on Dost et al.

Edwards, Paul C.

doi:10.1016/j.oooo.2013.12.399

Cited by 17 publications

(18 citation statements)

References 5 publications

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“…A follow-up editorial regarding this conclusion by Edwards (2014) 23 countered that, despite its limitations, OED grading gives a pathologist the best opportunity to convey the overall risk of malignancy to the clinician. Additionally, the authors agreed that molecular markers are needed to assist the pathologist and may eventually lead to a more definitive OED risk stratification.…”

Section: Discussionmentioning

confidence: 99%

Interobserver agreement in dysplasia grading: toward an enhanced gold standard for clinical pathology trials

Speight

Abram

Floriano

et al. 2015

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Objective Inter-observer agreement in the context of oral epithelial dysplasia (OED) grading has been notoriously unreliable and can impose barriers for developing new molecular markers and diagnostic technologies. This paper aimed to report the details of a 3-stage histopathology review and adjudication process with the goal of achieving a consensus histopathologic diagnosis of each biopsy. Study Design Two adjacent serial histological sections of oral lesions from 846 patients were independently scored by two different pathologists from a pool of four. In instances where the original two pathologists disagreed, a third, independent adjudicating pathologist conducted a review of both sections. If a majority agreement was not achieved, the third stage involved a face-to-face consensus review. Results Individual pathologist pair kappa values ranged from 0.251 – 0.706 (fair – good) before the 3-stage review process During the initial review phase, the two pathologists agreed on a diagnosis for 69.9% of the cases. After the adjudication review by a third pathologist, an additional 22.8% of cases were given a consensus diagnosis (agreement of 2 out of 3 pathologists). Following the face-to-face review, the remaining 7.3% of cases had a consensus diagnosis. Conclusion The use of the defined protocol resulted in a substantial increase (30%) in diagnostic agreement and has the potential to improve the level of agreement for establishing gold standards for studies based on histopathologic diagnosis.

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Section: Discussionmentioning

confidence: 99%

Interobserver agreement in dysplasia grading: toward an enhanced gold standard for clinical pathology trials

Speight

Abram

Floriano

et al. 2015

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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“…Clinicians are more likely to intervene when they come across a patient with moderate or severe OED, whereas a "wait and see" policy may be adopted for lesions showing only mild dysplasia. 58 Dost et al 15 demonstrated that 4.1% of mild dysplasias underwent malignant transformation and advocated surgical removal of lesions in all OED cases, irrespective of their histopathologic grade. Nevertheless, whether or not complete resection of all OED cases is warranted will not be discussed here, given that this topic is beyond the scope of our review and has been well reviewed by others.…”

Section: Epithelial Dysplasiamentioning

confidence: 99%

Oral potentially malignant disorders: risk of progression to malignancy

Speight

Khurram

Kujan

2018

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

389

388

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Oral potentially malignant disorders (OPMDs) have a statistically increased risk of progressing to cancer, but the risk varies according to a range of patient- or lesion-related factors. It is difficult to predict the risk of progression in any individual patient, and the clinician must make a judgment based on assessment of each case. The most commonly encountered OPMD is leukoplakia, but others, including lichen planus, oral submucous fibrosis, and erythroplakia, may also be seen. Factors associated with an increased risk of malignant transformation include sex; site and type of lesion; habits, such as smoking and alcohol consumption; and the presence of epithelial dysplasia on histologic examination. In this review, we attempt to identify important risk factors and present a simple algorithm that can be used as a guide for risk assessment at each stage of the clinical evaluation of a patient.

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“…Several “oral potentially malignant disorders” (OPMDs) have been recognized and associated with high risk of oral cancer. 45 These lesions include erythroplakia, leukoplakia (not to be confused with the Epstein-Barr virus-related oral hairy leukoplakia that occurs in immunocompromised PLWH), mixed red and white lesions, submucous fibrosis, and subtypes of lichen planus. 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.…”

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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The natural history of oral epithelial dysplasia: perspective on Dost et al.

Cited by 17 publications

References 5 publications

Interobserver agreement in dysplasia grading: toward an enhanced gold standard for clinical pathology trials

Interobserver agreement in dysplasia grading: toward an enhanced gold standard for clinical pathology trials

Oral potentially malignant disorders: risk of progression to malignancy

Screening for Cancer in Persons Living with HIV Infection

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