Malignant transformation of oral proliferative verrucous leukoplakia: a series of 48 patients with suggestions for management

Favia, Gianfranco; Capodiferro, Saverio; Limongelli, Luisa; Tempesta, Angela; Maiorano, Eugenio

doi:10.1016/j.ijom.2020.05.019

Cited by 20 publications

(40 citation statements)

References 37 publications

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“…32–34 ). Finally, 23 studies were included in the systematic review’s final sample—23 for qualitative evaluation and 21 for quantitative meta-analysis- [ 5 , 6 , 7 , 22 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ].…”

Section: Resultsmentioning

confidence: 99%

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Prognosis Parameters of Oral Carcinomas Developed in Proliferative Verrucous Leukoplakia: A Systematic Review and Meta-Analysis

González‐Moles

Warnakulasuriya

Ramos‐García

2021

Cancers

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Proliferative verrucous leukoplakia (PVL) is contemplated by the World Health Organization (WHO) as an oral potentially malignant disorder (OPMD) with a high the highest malignant transformation ratio among all OPMD (approximately 50%). Our aim was to evaluate the current evidence in relation to the prognosis of oral carcinoma developed in patients with proliferative verrucous leukoplakia (PVL-OC). We searched PubMed, Embase, Web of Science and Scopus for published studies (upper date limit = June 2021). We evaluated the quality of studies (QUIPS tool). We carried out meta-analyses, examined inter-study heterogeneity through subgroup and meta-regression analyses, and performed sensitivity and small-study effects analyses to test the stability and reliability of results. 23 studies met inclusion criteria (505 patients with PVL, of which 288 developed a total of 504 carcinomas). The meta-analyzed overall mortality rate was 21.29% (pooled proportions [PP] = 95% confidence intervals [CI] = 8.77–36.36) for PVL-OC, clearly lower than the 34.7–50% mortality rate for conventional oral cancer reported in previous studies. In comparison with a single study reporting on conventional oral cancers, mortality was significantly lower for PVL-OC (hazard ratio = 0.29 [95%CI = 0.10–0.89], p = 0.03). Univariable meta-regression verified that case series that presented higher proportions of verrucous carcinomas showed a better survival of PVL-OC (p = 0.05), but not with higher proportion of oral squamous cell carcinomas (p = 0.74). Significant differences were not found for other relevant variables such as follow up period (p = 0.44) or multiple tumor development (p = 0.74). In conclusion, PVL-OC show favorable prognostic parameters, especially with regard to the mortality rate.

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Section: Resultsmentioning

confidence: 99%

“…32-34). Finally, 23 studies were included in the systematic review's final sample-23 for qualitative evaluation and 21 for quantitative meta-analysis- [5][6][7]22,[37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55].…”

Section: Results Of the Literature Searchmentioning

confidence: 99%

Prognosis Parameters of Oral Carcinomas Developed in Proliferative Verrucous Leukoplakia: A Systematic Review and Meta-Analysis

González‐Moles

Warnakulasuriya

Ramos‐García

2021

Cancers

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“…Favia et al followed up forty-eight cases of PVL over a period ranging from eighteen months to two hundred and forty months to observe the malignant transformation and reported that fifteen out of forty-eight cases developed only one primary tumor, whereas the remaining thirty-three cases developed two or more primary tumors [ 24 ]. Upadhyaya et al [ 25 ] conducted a similar study in 2018 to find out the malignant potential of PVL and its possible association with Human Papilloma Virus (HPV).…”

Section: Discussionmentioning

confidence: 99%

Proliferative Verrucous Leukoplakia Revisited: A Retrospective Clinicopathological Study

Ghosh¹,

Rao

Upadhyay³

et al. 2021

Clinics and Practice

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(1) Objective: To review the criteria proposed by Cerero-Lapiedra et al. and to retrospectively identify the under-diagnosed disease in patients diagnosed with proliferative verrucous leukoplakia. (2) Materials and methods: In this study, we included patients who were diagnosed with leukoplakia (histological label consistent with the clinical diagnosis, n = 95), and cases with a final diagnosis within the spectrum of proliferative verrucous leukoplakia (n = 110) as defined by Batsakis et al. We applied the criteria proposed by Cerero-Lepiedra et al. to screen for the possible cases of proliferative verrucous leukoplakia. (3) Results: Although many of our patients satisfied specific isolated criteria, only 11 cases satisfied specific combinations of the guidelines to satisfy a diagnosis of proliferative verrucous leukoplakia. However, due to the lack of follow-up data, the disease is not confirmed in these 11 cases. (4) Conclusion: A limited number of cases of proliferative verrucous leukoplakia were diagnosed using the criteria given by Cerero-Lapiedra et al. The true natural history of the disease could not be studied due to the lack of follow-up data. (5) Clinical relevance: Proliferative verrucous leukoplakia presenting as hyperkeratosis or mild epithelial dysplasia are often not followed up, and they subsequently transform into carcinoma. Thus, clinicians must be vigilant whenever they encounter leukoplakia, especially with multifocal presentations. In such cases, the follow-up data are the key to understanding the true nature of the disease entity.

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“…Diode, Nd:YAG, KTP and CO 2 lasers may be useful when only gingival remodeling alone is necessary and this is essentially related to their surgical capabilities, especially contextual cuts and coagulation 2,9,11,12 . In fact, they are generally suggested for many surgical and non-surgical procedures in the oral cavity (frenectomy/frenulotomy, vestibuloplasty, mucosal biopsy, treatment of tooth hyper-sensibility, benign, potentially malignant and malignant lesions removal, surgical and not-surgical periodontal treatments including drug-related gingival overgrowth, photocoagulation of venous malformations, etc), but not for bone treatments [12][13][14][15][16][17][18][19] . When both gingival and bone remodelling is required, instead, the choice necessarily must fall on Er;Cr:YSGG or erbium:YAG lasers thanks to their selectivity for water, resulting in the capability to work by ablation on hard tissues as tooth and bone 10,11,20,21 .…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive (flapless) crown lengthening by erbium:YAG laser in aesthetic zone

et al. 2021

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Crown lengthening is a surgical procedure aimed at exposure of a larger tooth surface by gingivectomy alone or with cortical bone remodelling for aesthetic purposes in the anterior zone of the maxilla or for reconstruction of teeth affected by subgingival caries. We report two cases of crown lengthening in the anterior maxilla for aesthetic purposes by gingival and bone re-contouring performed by erbium-doped yttrium aluminium garnet (erbium:YAG) laser. As highlighted in this report, the erbium:YAG laser-assisted crown lengthening is less invasive and also leads to faster clinical outcomes in contrast to the conventional surgical technique by scalpel incision, flap elevation and osteoplastic.

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Malignant transformation of oral proliferative verrucous leukoplakia: a series of 48 patients with suggestions for management

Cited by 20 publications

References 37 publications

Prognosis Parameters of Oral Carcinomas Developed in Proliferative Verrucous Leukoplakia: A Systematic Review and Meta-Analysis

Prognosis Parameters of Oral Carcinomas Developed in Proliferative Verrucous Leukoplakia: A Systematic Review and Meta-Analysis

Proliferative Verrucous Leukoplakia Revisited: A Retrospective Clinicopathological Study

Minimally invasive (flapless) crown lengthening by erbium:YAG laser in aesthetic zone

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