Malignant Transformation of Oral Lichen Planus—An Umbrella Study of Systematic Reviews

Abstract

Oral lichen planus (OLP) is classified as a potentially malignant disorder. Systematic reviews collating longitudinal observation studies provide evidence of the rate or proportion of malignant transformation. We conducted an umbrella study of published systematic reviews. An extensive English-language study search was carried out in several databases to identify relevant articles, providing systematic reviews on the malignant transformation of OLP. Data from eight systematic reviews published between 2014 and 2023 are presented. The reported proportions of malignant transformation ranged from 1.1% to 1.4%. A meta-analysis based on the 10 highest-quality studies yielded a higher proportion of malignant transformation (2.28%). We list some limitations found in several of these systematic reviews. Some studies reported an increased risk of malignancy in OLP lesions, demonstrating epithelial dysplasia. In view of the consistent evidence of the risk of oral malignancy, OLP patients should be monitored carefully to detect early cancer development.

Successful treatment of erosive lichen planus with Upadacitinib complicated by oral squamous cell carcinoma

“…10 While another found that those with LP lesions on the tongue had 1.82 times the risk of developing oral SCC. 11 Unfortunately, it remains a challenge to determine the individual risk of malignancy in those with oral LP as there is currently no prognostic biomarker available to aid in identifying which oral LP lesions are at the highest risk for malignant transformation. 11 In this particular case, the identification of oral SCC was only possible after the clearance of the LP lesions by Upadacitinib.…”

“…11 Unfortunately, it remains a challenge to determine the individual risk of malignancy in those with oral LP as there is currently no prognostic biomarker available to aid in identifying which oral LP lesions are at the highest risk for malignant transformation. 11 In this particular case, the identification of oral SCC was only possible after the clearance of the LP lesions by Upadacitinib. This presents another challenge in monitoring for malignancy if SCC is being camouflaged by extensive disease.…”

Characteristics of Clinically Classified Oral Lichen Planus in Optical Coherence Tomography: A Descriptive Case-Series Study

“…Any form of OLP can degenerate malignantly over time. In various well-conducted studies, data on the malignant transformation rate of OLP range from 0.3% to 14.3% with an average of 1.1% and a median follow-up of about 5.5 years [ 9 , 11 , 15 ]. Malignant transformation can occur in all clinical types and mixed forms of OLP [ 12 , 14 ].…”

“…Based on chronic inflammation, this disease can also affect the skin, the scalp and the genital areas [ 8 , 9 ]. However, the oral form of lichen planus is primarily relevant as it leads to malignancy in about 1–2% of cases, which is more frequent than the cutaneous form [ 10 , 11 , 12 , 13 , 14 , 15 ]. This applies in particular if additional risk factors such as smoking, alcohol consumption or an infection with HPV are present [ 16 ].…”

Characteristics and malignancy transformation rate of 17 patients with oral erosive lichen planus: A case series

“…Among patients with oral lichen planus, there is an average malignant transformation of 1.1%, and 1.7% for the erosive form. 3 To study this further, and with the University of Nebraska Medical Center's IRB approval, we identified all OELP cases diagnosed clinically or via tissue biopsy between 2012 and 2022, yielding a total of 17 cases.…”