Malignant development of proliferative verrucous/multifocal leukoplakia: A critical systematic review, meta‐analysis and proposal of diagnostic criteria

Mendoza, Irene Lafuente‐Ibáñez de; Lorenzo-Pouso, Alejandro I.; Urízar, José Manuel Aguirre; Montero, Catalina Barba; Carrión, Andrés Blanco; Vila, Pilar Gándara; Pérez‐Sayáns, Mario

doi:10.1111/jop.13246

Cited by 23 publications

(21 citation statements)

References 47 publications

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“…On the other hand, PVL presents as a white plaque that tends to become multifocal with an aggressive, progressive and irreversible behaviour [7,11,12]. The rate of malignant transformation of PVL into OSCC or oral verrucous carcinoma varies from 14.3% to 75%, with an average rate ranging from 43.87% to 65.8% [13,14]. Unlike OL and OSCC, the aetiology of PVL is not always associated with the risk factors, such as tobacco, alcohol and areca [7,8,11,12].…”

Section: Introductionmentioning

confidence: 99%

High density of CD8 T cell and immune imbalance of T lymphocytes subsets are associated with proliferative verrucous leukoplakia

et al. 2022

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Oral leukoplakia (OL) and proliferative verrucous leukoplakia (PVL) are oral potentially malignant disorders (OPMDs) that microscopically show no or varying degrees of dysplasia. Even sharing clinical and microscopic aspects, PVL shows a more aggressive clinical behaviour, with a malignant transformation rate greater than 40%. Inflammatory infiltrate associated with dysplastic lesions may favour malignant transformation of OPMDs. This study aimed to evaluate the density of

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Section: Introductionmentioning

confidence: 99%

High density of CD8 T cell and immune imbalance of T lymphocytes subsets are associated with proliferative verrucous leukoplakia

et al. 2022

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“…9 Indeed, some multifocal cases of OE reviewed on this study, 22 multiple OPMD, such as OL, OLD, and proliferative multifocal/verrucous leukoplakia. [44][45][46] Unfortunately, we had several limitations during the performance of this systematic review and meta-analysis. First, is the low number of observational studies on the MD of OE, and with good clinical follow-up period of patients; and second, is the lack of standardization and changes in the diagnostic criteria for OE over the years.…”

Section: Discussionmentioning

confidence: 99%

“…In our review, almost half of the OE lesions had ED in the first biopsy, and presence of ED was six times higher than absence of ED (41.2% vs. 7.19%) (Table 4). Moreover, ED remains the most important prognostic factor in relation to the MD of multiple OPMD, such as OL, OLD, and proliferative multifocal/verrucous leukoplakia 44–46 …”

Section: Discussionmentioning

confidence: 99%

Critical update, systematic review, and meta‐analysis of oral erythroplakia as an oral potentially malignant disorder

Lorenzo-Pouso

Mendoza

Pérez‐Sayáns

et al. 2022

J Oral Pathology Medicine

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Background Oral erythroplakia has been classically considered as the potentially malignant disorder with the highest rate of malignant development into squamous cell carcinoma. This critical systematic review and meta‐analysis aim to estimate the malignant development rate of oral erythroplakia and identify the associated risk factors. Methods We performed a bibliographic search in PubMed, Scopus, Web of Science, Embase, and LILACS, with keywords “erythroplakia,” “erythroplasia,” “malignant transformation,” “malignant development,” “malignization,” “carcinogenesis,” “oral cancer,” “oral squamous cell carcinoma,” “mouth neoplasm,” and “prognosis.” Meta‐analysis was conducted using a random‐effects model. Results Ten observational studies with 441 patients met the inclusion criteria, whose mean malignant development rate was 12.7% and with a mean follow‐up period of patients of 6.66 years. In the initial biopsy, 42.8% of oral erythroplakia were already squamous cell carcinoma. The buccal mucosa was the most frequent location of oral erythroplakia, but the floor of the mouth was the most common site of malignant development. All patients who underwent malignant development showed epithelial dysplasia on the initial diagnostic biopsy. Conclusion Overall malignant development rate of OE in the meta‐analysis was 19.9%. We could not associate any specific clinicopathological feature with the malignant development. The presence of epithelial dysplasia in the initial biopsy remains the worst prognostic factor. Further observational studies on OE are needed, with well‐established diagnostic criteria and good clinical follow‐up, in order to identify the true risk of malignant development of oral erythroplakia and the related risk factors.

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“…The main risk factors of malignant transformation of OPMD described to date are patient-related, clinical (e.g., female, >50 years; non-smoker with a nonhomogeneous red lesion of the tongue and floor of mouth >200 mm 2 and existing for several years; history of previous OSCC; diabetes mellitus), tumor-related, histological (i.e., severe dysplasia), and molecular factors (i.e., aneuploidy, loss of heterozygosity [LOH]). The reported malignant transformation rates range from 3 to 66%, indicating that variable definitions may be used, data with different follow-up periods have been collected and the existence of histological and, in particular, molecular heterogeneity of OPMD [ 11 , 12 , 13 , 14 , 15 ]. For OPMDs that are visible, standard policy is to take multiple, repeated, and deep incision biopsies to check for invasive growth and dysplasia.…”

Section: Introductionmentioning

confidence: 99%

Unmet Needs and Perspectives in Oral Cancer Prevention

Bouaoud

Bossi

Elkabets

et al. 2022

Cancers

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Oral potentially malignant disorders (OPMD) may precede oral squamous cell carcinoma (OSCC). Reported rates of malignant transformation of OPMD range from 3 to 50%. While some clinical, histological, and molecular factors have been associated with a high-risk OPMD, they are, to date, insufficiently accurate for treatment decision-making. Moreover, this range highlights differences in the clinical definition of OPMD, variation in follow-up periods, and molecular and biological heterogeneity of OPMD. Finally, while treatment of OPMD may improve outcome, standard therapy has been shown to be ineffective to prevent OSCC development in patients with OPMD. In this perspective paper, several experts discuss the main challenges in oral cancer prevention, in particular the need to (i) to define an OPMD classification system by integrating new pathological and molecular characteristics, aiming (ii) to better identify OPMD at high risk of malignant transformation, and (iii) to develop treatment strategies to eradicate OPMD or prevent malignant transformation.

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Malignant development of proliferative verrucous/multifocal leukoplakia: A critical systematic review, meta‐analysis and proposal of diagnostic criteria

Cited by 23 publications

References 47 publications

High density of CD8 T cell and immune imbalance of T lymphocytes subsets are associated with proliferative verrucous leukoplakia

High density of CD8 T cell and immune imbalance of T lymphocytes subsets are associated with proliferative verrucous leukoplakia

Critical update, systematic review, and meta‐analysis of oral erythroplakia as an oral potentially malignant disorder

Unmet Needs and Perspectives in Oral Cancer Prevention

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