How should we manage oral leukoplakia?

The treatment of oral leukoplakia with the CO2 laser: A retrospective study of 65 patients

“…Malignant transformation of leukoplakia is independent of treatment, and it seems that areas with molecular preneoplastic changes may lead to multiple lesions (Yang et al, 2011;Ho et al, 2013;Kumar et al, 2013;L opez-Jornet and Camacho-Alonso, 2013). Despite advances in molecular biology, there are currently no markers to predict malignant transformation of oral leukoplakia; hence, several authors recommend excision of any leukoplakia whether or not dysplasia is present (van der Waal., 2009;Ho et al, 2013;Kumar et al, 2013;Brouns et al, 2014).…”

“…Despite advances in molecular biology, there are currently no markers to predict malignant transformation of oral leukoplakia; hence, several authors recommend excision of any leukoplakia whether or not dysplasia is present (van der Waal., 2009;Ho et al, 2013;Kumar et al, 2013;Brouns et al, 2014).…”

“…At a workshop coordinated by the WHO in 2005, "potentially malignant disorder" was the preferred terms, with the working group agreeing that the term leukoplakia should be used to recognize "white plaques of questionable risk having excluded (other) known diseases or disorders that carry no increased risk for cancer" (Warnakulasuriya et al, 2007). Prevalence of oral leukoplakia is reported to be approximately 2% (Petti, 2003;Brouns et al, 2013aBrouns et al, , 2013b and the annual malignant transformation rate is estimated to be between 0.13% and 17.5% (Deppe et al, 2012;Kumar et al, 2013;Brouns et al, 2014). Leukoplakia is considered to be the most common premalignant lesion of the oral cavity; its occurrence is related to smoking, with alcohol as an independent factor.…”

“…Incisional biopsy and histopathological examination are the gold standard in diagnosis. Early detection of oral lesions increases survival rates; hence, early and minimally invasive treatment would be indicated for those patients who would be expected to have low recurrence rates (Deppe et al, 2012;Brouns et al, 2013a;Kumar et al, 2013). Several treatments have been suggested in the literature, including surgery, electrosurgery, cryosurgery, topical agents (bleomycin, vitamin A), systemic agents (b-carotene, lycopene, retinoids), CO 2 laser and photodynamic treatment, although surgery and CO 2 laser are most frequently used.…”

Oral leukoplakia treatment with the carbon dioxide laser: A systematic review of the literature

“…Incisional biopsy and histopathological examination are the gold standard in the diagnosis of OL although, there may be discrepancies between the results for incisional biopsy compared to excisional biopsy, producing a potential underdiagnosis of dysplastic lesions by 28% and masking an OSCC diagnosis in 9% of the cases (Mogedas-Vegara et al, 2015;Brouns et al, 2014;Goodson et al, 2012;Van der Waal, 2009). Regarding follow-up examinations in patients with OL, there are authors that recommend a tight follow-up every 3 months in the first year, every 6 months in the second year and annually for life thereafter, but there is currently no evidence about the possible value of follow-up (Mogedas et al, 2015;Kumar et al, 2013;Van der Waal, 2009). To our knowledge this is the first systematic review of OL treatment with the CO 2 laser.…”