Development of squamous cell carcinoma from pre-existent oral leukoplakia: with respect to treatment modality

Saito, Tohru; Sugiura, Chihiro; Hirai, Atsuko; Notani, Ken‐ichi; Totsuka, Yasunori; Shindoh, Masanobu; Fukuda, Hiroshi

doi:10.1054/ijom.2000.0012

Cited by 103 publications

(99 citation statements)

References 19 publications

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“…Some frequently cited studies (e.g., 19) that associate transformation and dysplasia provide rates of transformation that are outliers in metanalysis (2). Many well-designed studies report almost no value (4,5,32,33) whereas others recommend combining grades to improve prediction (31). Reproducibility of grading is also problematic.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Dysplasia Grading and DNA Ploidy in Malignant Transformation of Oral Potentially Malignant Disorders

Sperandio

Brown

Lock

et al. 2013

Cancer Prevention Research

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Dysplasia grading is widely used to assess risk of transformation in oral potentially malignant disorders despite limited data on predictive value. DNA ploidy analysis has been proposed as an alternative. This study examines the prognostic value for both tests used in a routine diagnostic setting to inform clinical management. A retrospective study of conventional dysplasia grading was conducted on 1,401 patients. DNA ploidy analysis was conducted on a subset of 273 patients and results correlated with clinical information, pathologic diagnosis, and outcome over 5 to 15 years.Malignant transformation occurred in 32 of 273 patients (12%) and, of these, 20 (63%) of preexisting index lesions were aneuploid. Of 241 patients not developing carcinoma, only 39 (16%) of index lesions were aneuploid. Epithelial dysplasia correlated with DNA ploidy status (P < 0.001). The overall positive predictive value for malignant transformation by DNA aneuploidy was 38.5% (sensitivity 65.2% and specificity 75%) and by severe dysplasia grade 39.5% (sensitivity 30% and specificity 98%). DNA diploid and tetraploid status had negative predictive value of 90% to 96%. Combining DNA ploidy analysis with dysplasia grading gives a higher predictive value than either technique alone.Each of three traditional dysplasia grades predicts a significantly different risk of carcinoma development and time to transformation. DNA ploidy analysis had equivalent predictive value and also detected additional risk lesions in the absence of dysplasia. Cancer Prev Res; 6(8); 822-31. Ó2013 AACR.

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Section: Discussionmentioning

confidence: 99%

Predictive Value of Dysplasia Grading and DNA Ploidy in Malignant Transformation of Oral Potentially Malignant Disorders

Sperandio

Brown

Lock

et al. 2013

Cancer Prevention Research

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“…This definition excludes inflammatory conditions that may result in a red clinical appearance. Oral leukoplakia (OL) has an annual malignant transformation rate of 0.1-17% [13][14][15]. The included cases of potentially malignant disorders were classified according to Warnakulasuriya et al [16] into two groups 'no/questionable/hyperkeratosis/mild' = low risk epithelial dysplasia (LRED) and 'moderate or severe' = high risk epithelial dysplasia (HRED).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Myofibroblasts Expression in Oral Squamous Cell Carcinoma, Verrucous Carcinoma, High Risk Epithelial Dysplasia, Low Risk Epithelial Dysplasia and Normal Oral Mucosa

Chaudhary

Gadbail

Vidhale

et al. 2012

Head and Neck Pathol

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The aim was to evaluate and compare the presence of myofibroblasts in oral squamous cell carcinoma (OSCC), verrucous carcinoma (VC), high-risk epithelial dysplasia (HRED), low-risk epithelial dysplasia (LRED), and normal oral mucosa (NOM). The study consisted of 37 OSCC, 15 VC, 15 HRED, 15 LRED and 15 NOM. a-smooth muscle actin (a-SMA) antibody was used to identify myofibroblasts. The a-SMA expression was not observed in NOM and LRED. The a-SMA was expressed in 97.29% of OSCC, 86.66% of VC, 46.66 % of HRED. The a-SMA expression was significantly higher in OSCC than VC (p = 0.023) and HRED (p \ 0.000). The a-SMA expression was significantly higher in VC than HRED (p = 0.043). Myofibroblastic expression, as highlighted by a-SMA, is undetectable in NOM and LRED but increases as the disease progresses from potentially malignant disorders, as HRED to VC to invasive OSCC. Thus, proliferation of myofibroblasts may be used as a stromal marker of oral premalignancy and malignancy.

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“…Moreover, when OL involves large areas of the mucosa, laser surgery is the first choice treatment, as it allows for healing by secondary intention. 8,9 The purpose of this study was to assess the usefulness of treating OL lesions with CO 2 and diode lasers and to analyze factors that may affect recurrence, development of new lesions, and malignant transformation.…”

Section: 5005/jp-journals-10024-2125mentioning

confidence: 99%

“…At the same time, clinicians must be aware that cancer may arise from "harmless" types of lesions, exhibiting mild or no dysplasia, localized at low-risk areas, or presenting a homogeneous surface. [1][2][3][4] In considering whether or not to treat OL, it is important to bear in mind that there is no scientific evidence…”

Section: Introductionmentioning

confidence: 99%

Factors affecting Clinical Outcomes after Treatment of Oral Leukoplakia with CO2 and Diode Laser

Galletta

Azevedo

Lodi

et al. 2017

The Journal of Contemporary Dental Practice

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Introduction:To analyze factors that may affect recurrence, development of new lesions, and malignant transformation in patients with oral leukoplakia (OL) following surgical treatment with lasers. Materials and methods:A total of 40 patients were enrolled in this study, 17 females (mean age of 64.5 years; 33-88 years) and 23 males (mean age of 56.6 years; 28-84 years) with an overall mean age of 60.5 years. A total of 49 lesions were diagnosed and treated; 9 patients had more than one site affected. Mean time of follow-up was 22 months (6-71 months). Data were assessed by univariate Cox and multivariate Cox regression analyses. Results:Recurrence (OL at the same site of the initial lesion) was observed in 11 patients (27.5%) while 4 patients (10%) developed new lesions, and 2 patients (5%) experienced malignant transformation. Only two clinical factors were statistically associated with the outcome for the development of new lesions: patients ≥ 60 years and female gender (p < 0.1). Neither of the outcomes of recurrences and malignant transformations was significantly correlated with any of the risk factors analyzed. Conclusion:Surgical laser is not a deterrent for the outcomes evaluated; additionally, the design of this study did not allow us to determine whether the laser treatment had provided a great benefit by significantly reducing the rate of malignant transformation among the patients.

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Development of squamous cell carcinoma from pre-existent oral leukoplakia: with respect to treatment modality

Cited by 103 publications

References 19 publications

Predictive Value of Dysplasia Grading and DNA Ploidy in Malignant Transformation of Oral Potentially Malignant Disorders

Predictive Value of Dysplasia Grading and DNA Ploidy in Malignant Transformation of Oral Potentially Malignant Disorders

Comparison of Myofibroblasts Expression in Oral Squamous Cell Carcinoma, Verrucous Carcinoma, High Risk Epithelial Dysplasia, Low Risk Epithelial Dysplasia and Normal Oral Mucosa

Factors affecting Clinical Outcomes after Treatment of Oral Leukoplakia with CO2 and Diode Laser

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