Treatment results of CO₂ laser vaporisation in a cohort of 35 patients with oral leukoplakia

Abstract

The results in the present study are worse than those reported in the literature, perhaps owing to the use of different diagnostic criteria for OL, differences in the employed laser technique and assessment of possible recurrences by an independent clinician.

The treatment of oral leukoplakia with the CO2 laser: A retrospective study of 65 patients

“…Dysplasia severity is the most common risk factor associated with malignant transformation (Chandu and Smith, 2005;Goodson et al, 2012); however, we could not demonstrate this fact in our sample. No randomized trials are reported in the literature that compare surgery with CO 2 laser in terms of local recurrence and malignant transformation (Brouns et al, 2013a). The recurrence and malignant transformation rates for our sample were 33.8% and 15.4%, respectively, comparable with those found in literature (7.7%e40% for recurrences and 0.83%e14% for malignant transformation; Table 4) (Chiesa et al, 1993;Schoelch et al, 1999;Thomson, 2002;Thomson and Wylie, 2002;Chandu and Smith, 2005;Van der Hem et al, 2005;Yang et al, 2011;Deppe et al, 2012;Jerjes et al, 2012;Brouns et al, 2013aBrouns et al, , 2014.…”

“…KaplaneMeier curves for time to recurrence showed differences only for the location of the lesion in the gingiva compared to the location on the tongue (log rank p ¼ 0.032). Brouns et al, 2013aBrouns et al, , 2014. In our cohort, the tongue was also the most frequent location (n ¼ 21, 32.3%).…”

“…CO 2 laser can be used for both excision and vaporization. For vaporization, preferred for large lesions, a prior biopsy is necessary (Chandu and Smith, 2005;Santos et al, 2010;Deppe et al, 2012;Brouns et al, 2013aBrouns et al, , 2014. Vaporization has also been used to resect small (T1/T2) oral squamous cell carcinoma (OSCC), with results comparable to those of surgery (Jerjes et al, 2011).…”

“…Incisional biopsy and histopathological examination are the gold standard in diagnosis. Early detection of oral lesions increases survival rates; hence, early and minimally invasive treatment would be indicated for those patients who would be expected to have low recurrence rates (Deppe et al, 2012;Brouns et al, 2013a;Kumar et al, 2013). Several treatments have been suggested in the literature, including surgery, electrosurgery, cryosurgery, topical agents (bleomycin, vitamin A), systemic agents (b-carotene, lycopene, retinoids), CO 2 laser and photodynamic treatment, although surgery and CO 2 laser are most frequently used.…”

“…At a workshop coordinated by the WHO in 2005, "potentially malignant disorder" was the preferred terms, with the working group agreeing that the term leukoplakia should be used to recognize "white plaques of questionable risk having excluded (other) known diseases or disorders that carry no increased risk for cancer" (Warnakulasuriya et al, 2007). Prevalence of oral leukoplakia is reported to be approximately 2% (Petti, 2003;Brouns et al, 2013aBrouns et al, , 2013b and the annual malignant transformation rate is estimated to be between 0.13% and 17.5% (Deppe et al, 2012;Kumar et al, 2013;Brouns et al, 2014). Leukoplakia is considered to be the most common premalignant lesion of the oral cavity; its occurrence is related to smoking, with alcohol as an independent factor.…”