Oral proliferative verrucous leucoplakia: are there particular features for such an ambiguous entity? A systematic review

Abstract

Proliferative verrucous leucoplakia (PVL) is a distinct, particularly aggressive form of oral leucoplakia. Given the low prevalence of PVL, data are sparse and are mostly from case reports, case series and only a few case-control studies, meaning that the literature is able to provide only weak evidence. The present systematic literature review aims to collate the available evidence on the following issues: patient demographics, aetiology, lesion location(s), malignant potential, location and histopathological features of transformed lesions, disease-specific survival rates and treatment response. Electronic databases were searched for studies in the English language reporting original data from at least 10 patients with PVL on the target issues of the present review. The retrieved data were merged and a descriptive analysis performed. The 20 studies selected indicated that PVL does not seem to be correlated with the major risk factors for oral carcinoma (tobacco, alcohol and/or areca nut/betel leaf chewing). The disorder affects mainly adult/elderly women and has a very high malignant transformation rate, particular site distribution and particular location and histopathological features of transformed lesions. The present results may be limited by some articles being unintentionally excluded as they were not found during the electronic search, a lack of worldwide accepted diagnostic criteria for PVL, and overlapping data from multiple studies performed in a limited number of centres. Despite these potential drawbacks, the present results demonstrate that PVL does have particular features.

Malignant transformation rate of oral leukoplakia in an Australian population

“…Higher risk OLK includes those that are larger, non‐homogeneous, exhibit a loss of autofluorescence on imaging and display features of OED, with the risk increasing with the grade . Proliferative verrucous leukoplakia (PVL) is a particularly aggressive variant of OLK characterised by multifocal lesions and a corrugated clinical appearance, and displays a particularly high MT rate of between 40% and 70% …”

Salivary and serum interleukin-6 levels in proliferative verrucous leukoplakia

“…This is a potentially malignant disorder with a risk of malignant transformation into oral squamous cell carcinoma (OSCC) of up to 70 %, according to some authors [2][3][4][5][6][7].…”

Hochrisiko-Leukoplakien sicher identifizieren

“…Die proliferative verruköse Leukoplakie ist stets als Hochrisikoläsion zu werten, sie geht mit einem Entartungsrisiko von 60 % innerhalb von sieben Jahren einher [13].…”

“…Bei der proliferativen, verrukösen Leukoplakie sind engmaschige lebenslange klinische sowie histologische Kontrollen angezeigt, um eine maligne Transformation frühzeitig zu erkennen [13]. Je nach Anamnese sollte jedem Patienten das Einhalten von strikter Nikotin-und Alkoholkarenz geraten werden.…”

“…1) ist eine aggressive Sonderform der Leukoplakie. Sie zeichnet sich durch ein multilokuläres Au reten, die Bevorzugung des weiblichen Geschlechts und den meist fehlenden Zusammenhang mit anamnestischen Risikofaktoren aus [13].…”