Risk assessment of malignant transformation of oral leukoplakia in patients with previous oral squamous cell carcinoma

• Published in: International journal of oral and maxillofacial surgery 2022-11, Vol.51 (11), p.1394-1400
• Main Authors: Yang, S.-W., Lee, Y.-C., Lee, Y.-S., Chang, L.-C., Lai, Y.-R.
• Format: Article
• Language: English
• Subjects: carbon dioxide laser; history; neoplastic cell transformation; oral leukoplakia; oral squamous cell carcinoma
• ISSN: 0901-5027; 1399-0020
• DOI: 10.1016/j.ijom.2022.02.006

The aim of this study was to identify the risk factors associated with developing oral squamous cell carcinoma (OSCC) from surgically excised oral leukoplakia (OL) in patients with previous oral cavity cancer. Clinicopathological data of 84 patients who were treated for OL between July 2002 and July 2020 and who had previously received treatment for OSCC were reviewed retrospectively. The follow-up time ranged from 0.69 to 17.99 years (mean 6.78 ± 4.25 years). The overall cumulative malignant transformation rate was 25% and the annual transformation rate was 5.73%. Kaplan–Meier survival analysis and the log-rank test showed that Candida infection (P = 0.010) was a risk factor associated with malignant transformation. In the multivariate Cox regression analysis, tongue and floor of the mouth as the location of the leukoplakia (P = 0.039), multifocal lesions of OL (P = 0.047), and Candida infection (P = 0.018) were the three independent prognostic factors related to the development of OSCC from the treated OL. A cautious approach to OL of the tongue with Candida infection or multifocal disease in this group of patients would be appropriate.