Malignant transformation in 5071 southern Taiwanese patients with potentially malignant oral mucosal disorders

Abstract

BackgroundOral cancers can be preceded by clinically evident oral potentially malignant disorders (OPMDs). The current study evaluated the rate and the time of malignant transformation in the various OPMDs in a cohort of patients from southern Taiwan. Parameters possibly indicative for malignant transformation of OPMDs, such as epidemiological and etiological factors, and clinical and histopathological features were also described.MethodsWe followed-up 5071 patients with OPMDs—epithelial dysplasia with oral submucous fibrosis, epithelial dysplasia with hyperkeratosis/epithelial hyperplasia, hyperkeratosis/epithelial hyperplasia, oral submucous fibrosis, lichen planus, and verrucous hyperplasia—between 2001 and 2010 for malignant transformation.ResultsTwo hundred nineteen of these 5071 OPMD patients (202 men, 17 women; mean age: 51.25 years; range: 30–81 years) developed oral cancers (179 squamous cell carcinomas; 40 verrucous carcinomas) in the same sites as the initial lesions at least 6 months after their initial biopsies. The overall transformation rate was 4.32% (mean duration of transformation: 33.56 months; range: 6–67 months). Additionally, the mean time of malignant transformation was significantly shorter for lesions with than without epithelial dysplasia. The risk of malignant transformation was 1.89 times higher for epithelially dysplastic than non-dysplastic lesions. The anatomical site of OPMD and the presence of epithelial dysplasia were significantly associated with malignant transformation. The hazard rate ratio was 1.87 times larger for tongue lesions than for buccal lesions.ConclusionPatients with OPMDs require long-term follow up.

Long-term outcome of non-surgical treatment in patients with oral leukoplakia

“…Previous studies have reported that men underwent malignant transformation more frequently than women [15,16]. In the present study, the expansion of lesion and malignant transformation were more frequent in men than in women.…”

“…Several studies have evaluated the clinicopathological factors predictive of malignant transformation in patients with oral leukoplakia and demonstrated significant differences in age, gender, cite of lesion, size of lesion, number of sites affected, and clinical and pathological appearance of the lesions [12][13][14][15][16][17][18][19]. In the present study, the lesions that were non-homogenous and located on the tongue presented with a higher grade were likely to progress into cancer.…”

“…Table 3 showed that 16 of 25 lesions (64.0%) by smoking cessation and 9 of 17 lesions (52.9%) by occlusal adjustment were led in reduction and disappearance. Smoking cessation was one of the most important factors found to increase the disappearance of oral leukoplakia, as reported previously [1,15,16]. It is very difficult to establish whether the lesions had an actual correlation with smoking because of the difference in the smoking amount, frequency, race, and many other factors modifying the risk of oral preneoplasia and cancer.…”

Saliva protein biomarkers to detect oral squamous cell carcinoma in a high-risk population in Taiwan

“…On the other hand, 18 cases in the OPMD II group showed malignant transformation to OSCC within 1.2-65.5 mo; these cases included 1 each of erythroleukoplakia, erythroplakia plus submucous fibrosis, submucous fibrosis, and speckle leukoplakia, 4 cases of verrucous hyperplasia, and 10 cases of verrucous hyperplasia plus submucous fibrosis. In this cohort, the malignant transformation rate of the OPMD II patients was about 20.5% (18/88), which was twofold higher than that among the OPMD patients (11.8%, 18/153) (18)(19)(20). The clinical characteristics and follow-up data of the 88 OPMD II cases are detailed in SI Appendix, Table S10.…”

Leucoplasia Oral: conceitos e repercussões clínicas

“…3,5,8,9,18,21 Não há dúvidas de que o CCE representa 90% dos cânceres de boca, tendo em vista sua alta incidência em nosso meio, caracterizando-o como a neoplasia maligna mais comum na cavidade oral. 2,4,[12][13][14][15][16]19,20 3 Parlatescu et al, 4 Patrício 5 e Rodrigues et al 6 concordam que se trata da lesão pré maligna mais comum. Torras et al, 2 Parlatescu et al, 4 Patrício, 5 Neville et al 10 e Abidullah et al 21 justificam sua significância ao afirmarem que CCEs orais vêm sendo associados ou precedidos de lesões pré-malignas, com destaque para a LO.…”