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

Abstract

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.

Importance of the vaporization margin during CO2 laser treatment of oral leukoplakia: A survival study

“…According to the literature, numerous factors can provoke the recurrence of OL after laser treatment (Galletta et al, 2017). In a retrospective study that analysed lingual OL lesions treated with CO 2 laser excision, when performing the multivariate logistic regression study, the only prognostic factor for recurrence was the size of the lesion (Yang et al, 2021).…”

Difficulties in the Prognostic Study of Oral Leukoplakia: Standardisation Proposal of Follow-Up Parameters

“…The number of studies that do not track alcohol and tobacco use is striking, considering that these are already malignant transformation-associated factors supported by scientific evidence, so tracking habits or their cessation should be considered a priority. Discrepancies regarding the definition, quantity, and frequency of consumption were observed, both with smoking and alcohol [ 17 , 50 ]. The multiplicity of criteria implies a wide variability in its categorisation.…”

“…We define evolution as the course presented by patients since diagnosis, reported during the follow-up, including no changes in clinical presentation, total or partial improvements, progression in the extent or grade of dysplasia, malignant transformation, and new lesions in the oral cavity. This parameter was reported in 35 investigations, many with different definitions of recurrence [ 10 , 17 ], reporting a recurrence rate of between 10 and 35% [ 57 ].…”

Application of Texture and Fractal Dimension Analysis to Estimate Effectiveness of Oral Leukoplakia Treatment Using an Er:YAG Laser—A Prospective Study

“…A similar recurrence level was reported by Galletta et al, in the case of CO 2 laser applied in leukoplakia treatment. The recurrence rate was 37.5% [ 31 ]. Del Corso et al had the longest period of follow up (60 months).…”