Scott C Borgna1, Peter T Clarke2, Andrew G Schache3,4, Derek Lowe4, Michael W Ho3,5, Caroline E McCarthy3,6, Stephen Adair6, E Anne Field6, John K Field3,6, Deborah Holt6, Janet M Risk3, Bijay P Rajlawat6, Asterios Triantafyllou7, Richard J Shaw3,6,4. 1. Royal Brisbane and Women's Hospital Metro North Hospital and Health Service, Department of Oral and Maxillofacial Surgery, Brisbane, Queensland, Australia. 2. Department of Restorative Dentistry, Central Manchester Foundation Trust, Manchester, United Kingdom. 3. Mersey Head and Neck Oncology Research Group (MHNORG), Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom. 4. Division of Oral and Maxillofacial Surgery, Aintree University Hospitals NHS Foundation Trust, Liverpool, United Kingdom. 5. Leeds Teaching Hospitals NHS Trust, Oral and Maxillofacial Surgery, Leeds Dental Institute, Leeds, United Kingdom. 6. Department of Oral Medicine, Liverpool University Dental Hospital, Liverpool, United Kingdom. 7. Pathology Department, Liverpool Clinical Laboratories and School of Dentistry, University of Liverpool, Liverpool, United Kingdom.
Abstract
BACKGROUND: Proliferative verrucous leukoplakia (PVL) is a progressive, multifocal, exophytic form of leukoplakia with high rates of malignant transformation. The purpose of this study was to evaluate a cohort of patients with PVL in a single tertiary referral clinic. METHOD: Cases meeting accepted diagnostic criteria were reviewed with regard to their pathology, demographic characteristics, management, and outcomes. Human papillomavirus (HPV) testing was undertaken on a subset. RESULTS: Almost half of the 48 patients with PVL (48%; n = 23) underwent malignant transformation after a median 23.4 months. The characteristics of this cohort were similar to those previously described, but management was notably more conservative. Conservative management of PVL was used in 92% of our patients, but the clinical outcomes seem comparable with previously described cohorts in which PVL was predominantly treated by surgical excision. All HPV testing was negative. CONCLUSION: Aggressive surgical intervention in the premalignant phase of PVL may not influence the rate of malignant transformation.
BACKGROUND: Proliferative verrucous leukoplakia (PVL) is a progressive, multifocal, exophytic form of leukoplakia with high rates of malignant transformation. The purpose of this study was to evaluate a cohort of patients with PVL in a single tertiary referral clinic. METHOD: Cases meeting accepted diagnostic criteria were reviewed with regard to their pathology, demographic characteristics, management, and outcomes. Human papillomavirus (HPV) testing was undertaken on a subset. RESULTS: Almost half of the 48 patients with PVL (48%; n = 23) underwent malignant transformation after a median 23.4 months. The characteristics of this cohort were similar to those previously described, but management was notably more conservative. Conservative management of PVL was used in 92% of our patients, but the clinical outcomes seem comparable with previously described cohorts in which PVL was predominantly treated by surgical excision. All HPV testing was negative. CONCLUSION: Aggressive surgical intervention in the premalignant phase of PVL may not influence the rate of malignant transformation.
Authors: Gian Paolo Bombeccari; Umberto Garagiola; Valentina Candotto; Francesco Pallotti; Francesco Carinci; Aldo Bruno Giannì; Francesco Spadari Journal: Maxillofac Plast Reconstr Surg Date: 2018-07-30