Primali Rukmal Jayasooriya1, Kitmini Dayaratne2,3, Upul Bandara Dissanayake2, Saman Warnakulasuriya4. 1. Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, 20400, Sri Lanka. primalij@yahoo.com. 2. Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, 20400, Sri Lanka. 3. Department of Medical Laboratory Sciences, Faculty of Allied Health Science, University of Peradeniya, Peradeniya, 20400, Sri Lanka. 4. Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
Abstract
OBJECTIVE: The main objective of the study was to identify the determinants that contribute to the malignant transformation of oral leukoplakia in a group of patients managed in secondary care. A secondary objective was to compare two dysplasia grading systems to determine their utility in assessing the prognosis. MATERIAL AND METHODS: The cohort consisted of 93 patients diagnosed during the period 2009-2013. The variables recorded and analysed included age and sex, clinical presentation (colour) and severity of oral epithelial dysplasia (OED) scored by the WHO (2005) and the binary grading systems. The planned management included excision of high-grade dysplasia and observation of low-grade dysplasia lesions based on the WHO grading system. Patient factors were transcribed from the pathology records and updated using a questionnaire sent out to the whole group of patients. Data were analysed using χ2 test and Kaplan-Meier analysis (P < 0.05). RESULTS: Complete follow-up data were available for 93 patients. Malignant transformation occurred in 7 patients (7.5%) during a mean follow-up period of 30 months. Among the surgically excised group (n = 51), a recurrence of oral leukoplakia was noted in 16 patients (31%). WHO OED grading (P = 0.02) and the presence of red areas (P = 0.012) were useful in predicting malignant transformation with severe epithelial dysplastic lesions and red and white mixed lesions showing higher rates. CONCLUSION: Leukoplakias (7.5%) transformed over a mean follow-up period of 30 months. Dysplasia grading and the clinical appearance by colour (mixed white and red) were significant predictors of malignant transformation CLINICAL SIGNIFICANCE: Patients with erythroleukoplakia and those diagnosed with moderate or severe epithelial dysplasia require more intensive interventions as such lesions have a higher risk of developing a malignancy.
OBJECTIVE: The main objective of the study was to identify the determinants that contribute to the malignant transformation of oral leukoplakia in a group of patients managed in secondary care. A secondary objective was to compare two dysplasia grading systems to determine their utility in assessing the prognosis. MATERIAL AND METHODS: The cohort consisted of 93 patients diagnosed during the period 2009-2013. The variables recorded and analysed included age and sex, clinical presentation (colour) and severity of oral epithelial dysplasia (OED) scored by the WHO (2005) and the binary grading systems. The planned management included excision of high-grade dysplasia and observation of low-grade dysplasia lesions based on the WHO grading system. Patient factors were transcribed from the pathology records and updated using a questionnaire sent out to the whole group of patients. Data were analysed using χ2 test and Kaplan-Meier analysis (P < 0.05). RESULTS: Complete follow-up data were available for 93 patients. Malignant transformation occurred in 7 patients (7.5%) during a mean follow-up period of 30 months. Among the surgically excised group (n = 51), a recurrence of oral leukoplakia was noted in 16 patients (31%). WHO OED grading (P = 0.02) and the presence of red areas (P = 0.012) were useful in predicting malignant transformation with severe epithelial dysplastic lesions and red and white mixed lesions showing higher rates. CONCLUSION:Leukoplakias (7.5%) transformed over a mean follow-up period of 30 months. Dysplasia grading and the clinical appearance by colour (mixed white and red) were significant predictors of malignant transformation CLINICAL SIGNIFICANCE: Patients with erythroleukoplakia and those diagnosed with moderate or severe epithelial dysplasia require more intensive interventions as such lesions have a higher risk of developing a malignancy.
Authors: Brunno Santos de Freitas Silva; Danielle Coelho Ribeiro Batista; Camila Ferro de Souza Roriz; Lorena Rosa Silva; Ana Gabriela Costa Normando; Alan Roger Dos Santos Silva; Maria Alves Garcia Silva; Fernanda Paula Yamamoto-Silva Journal: Clin Oral Investig Date: 2021-05-29 Impact factor: 3.573
Authors: Aida Kusiak; Adrian Maj; Dominika Cichońska; Barbara Kochańska; Aleksandra Cydejko; Dariusz Świetlik Journal: Int J Environ Res Public Health Date: 2020-09-22 Impact factor: 3.390