Hospital-based epidemiological and clinical characterisation of the malignant transformation of oral leukoplakia in a Chinese population

Lyu, Mingyue; Guo, Yuxiao; Li, Shuo; Yang, Di; Hua, Hong

doi:10.1111/idj.12292

Cited by 7 publications

(5 citation statements)

References 33 publications

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“…The primary goal of OLK is to prevent malignant transformation. The rate of malignant transformation in this study was 4%, which is comparable to the rate of OLK malignancy reported in other studies [ 37 ]. Owing to the short follow-up time and relatively small sample size, the effect of topical PDT on OLK malignant transformation could not be assessed in this study.…”

Section: Discussionsupporting

confidence: 87%

Clinical evaluation of photodynamic therapy for oral leukoplakia: a retrospective study of 50 patients

Wang,

Tang,

Wang

et al. 2024

BMC Oral Health

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Background Topical photodynamic therapy (PDT) has demonstrated encouraging results in the treatment of oral leukoplakia (OLK). However, data on the clinical efficacy of PDT in Chinese patients with OLK are still limited. Methods Fifty patients diagnosed with OLK were enrolled, including patients with various dysplastic tissues. All patients received topical PDT with 5-aminolevulinic acid (5-ALA) as a photosensitizer. Clinical efficacy was evaluated 4 weeks after treatment. Follow-up was performed every 3 months during the first year and every 6 months during the second year. Results The overall response rate was 68% (34/50): 12% (n = 6) complete and 56% (n = 28) partial responses. Aneuploidy was reduced in the patients with dysplastic lesions. Oral pain and local ulcers developed in 52% of the patients (n = 26). Patients with a long history of OLK including hyperplasia and dysplastic lesions, as well as those with non-homogenous lesions, were more likely to develop pain and ulcer. During follow-up, the recurrence rate of hyperplasia and dysplastic lesions was 32% (n = 16) and the malignant transformation rate of dysplastic lesions was 4% (n = 2). Lesions on the buccal mucosa were associated with recurrence (P = 0.044; OR: 0.108, 95% CI: 0.013–0.915). Conclusion Topical 5-ALA-mediated PDT is an effective treatment for OLK, particularly for homogenous leukoplakia, with few side effects. The buccal mucosa may be a protective factor that can reduce recurrence.

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Section: Discussionsupporting

confidence: 87%

Clinical evaluation of photodynamic therapy for oral leukoplakia: a retrospective study of 50 patients

Wang,

Tang,

Wang

et al. 2024

BMC Oral Health

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“…OL is a well-known oral potentially malignant disorder (OPMD) with a potential risk of malignancy. It has been reported that 15.8–48.0% of patients with oral squamous cell carcinoma (OSCC) have a history of OL when diagnosed 5 . According to a systematic review of 24 retrospective studies, the prevalence rate of OL is 0.13–34% 6 .…”

Section: Introductionmentioning

confidence: 99%

Application of 5-aminolevulinic acid-mediated Waterlase-assisted photodynamic therapy in the treatment of oral leukoplakia

Gao

et al. 2022

Sci Rep

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Photodynamic therapy (PDT) is an alternative microinvasive approach with satisfying results in the treatment of oral leukoplakia (OL). PDT combined with laser irradiation shows promise, safety and efficacy in treating OL. The efficacy of waterlase (YSGG) combined with PDT was studied by brush and tissue biopsy. Seventy-one patients with histologically diagnosed OL were enrolled, including patients with mild to moderate dysplasia, severe dysplasia and various dysplastic tissues. Patients were evaluated at baseline (t0), the end of treatment (t1) and 1 year later (t2). At t1, PDT showed a significant therapeutic effect on OL with mild to moderate dysplasia. Clinical and histological examinations revealed 60 cases (84.51%) of complete remission and 11 cases (15.49%) of partial remission. On brush biopsy, all PDT-treated patients showed reduced aneuploidy and normal histological findings. Unfortunately, at t2, 9 patients relapsed with OL, which may be related to continued smoking and betel nut chewing. At t2, 5 patients developed new severe epithelial dysplasia and even carcinoma in situ in other areas, mostly the tongue. ALA-mediated PDT combined with YSGG is effective in treating OL, particularly that with mild to moderate dysplasia. However, severe dysplasia may present undesirable effects, and the mechanism remains to be further investigated. ALA-mediated PDT combined with YSGG provides a new method for OL treatment.

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“…According to the findings of previous hospital-based cohort studies in China, the pooled malignant transformation rate of OLK was 9% (7% for homogeneous OLK and 25% for nonhomogeneous OLK). 54 In mainland China, although the number of oral medicine specialists is small (estimated at 1 in 5,000,000), consultation from an oral medicine specialist is available for all patients. Patients can make an online reservation 1 to 2 weeks before the visit and the cost of each consultation is around US$5 to US$50.…”

Section: Discussionmentioning

confidence: 99%

Management of oral leukoplakia: a position paper of the Society of Oral Medicine, Chinese Stomatological Association

Chen¹,

Dan²,

Pan

et al. 2021

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Objective. The objective of this study was to develop the first edition of a Chinese evidence-based position paper on the management of oral leukoplakia (OLK). Study Design. The consultant group for drafting the position paper consisted of 31 oral medicine specialists and 2 evidence-based medicine specialists. English studies (searched in PubMed, EMBASE, and the Cochrane Library) and Chinese studies (searched in China National Knowledge Infrastructure and WanFang) published before January 2018 were used. The quality of the study was assessed using the Grading of Recommendations Assessment, Development, and Evaluation grid, and the strength of the recommendations was determined based on the results of 3 rounds of voting among the consultant group members using the Delphi method. Results. Twenty-two evidence-based guidelines for clinical management and monitoring of OLK were established in this position paper. A clinical path diagram for oral health practitioners was constructed based on the recommendations. Conclusion. Current evidence suggests that management and monitoring of patients with OLK should be performed by experienced clinicians to control the lesion and for early detection of malignant transformation. However, all recommendations are based on evidence of low or extremely low quality and may require further modification as new evidence is produced. (Oral Surg Oral Med Oral Pathol Oral Radiol 2021;000:1À12)

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Hospital-based epidemiological and clinical characterisation of the malignant transformation of oral leukoplakia in a Chinese population

Abstract: Our findings show that female gender, age >50 years and non-homogeneous OL are risk factors for malignant transformation. It is important to develop clinical strategies to educate, diagnose and treat patients with OL and to minimise the MTR of OL.

Cited by 7 publications

References 33 publications

Clinical evaluation of photodynamic therapy for oral leukoplakia: a retrospective study of 50 patients

Clinical evaluation of photodynamic therapy for oral leukoplakia: a retrospective study of 50 patients

Application of 5-aminolevulinic acid-mediated Waterlase-assisted photodynamic therapy in the treatment of oral leukoplakia

Management of oral leukoplakia: a position paper of the Society of Oral Medicine, Chinese Stomatological Association

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