A Retrospective Cohort Study of Oral Leukoplakia in Female Patients-Analysis of Risk Factors Related to Treatment Outcomes.

Shih-Wei Yang,Liang-Che Chang,Yun-Shien Lee,Cheng-Cheng Hwang,Pei-Wen Wu

doi:10.3390/ijerph18168319

Abstract

Background: The aim of this study was to make a comparison of clinicopathological characteristics of oral leukoplakia between male and female patients following carbon dioxide laser excision for oral leukoplakia and analyze the factors associated with the treatment outcomes in female patients. Methods: Medical records of patients with oral leukoplakia receiving laser surgery from 2002 to 2020 were retrospectively reviewed and analyzed statistically. Results: A total of 485 patients were enrolled, including 412 male (84.95%) and 73 female (15.05%). Regarding the locations, the predilection site of oral leukoplakia in male patients was buccal mucosa (p = 0.0001) and that for women patients was tongue (p = 0.033). The differences of recurrence and malignant transformation between both sexes were not significant (p > 0.05). Among female patients, area of oral leukoplakia was the risk factor related to recurrence (p < 0.05). Clinical morphology and postoperative recurrence were the risk factors related to malignant transformation (p < 0.05). Conclusions: In comparison with male patients, there was no significant difference of the postoperative recurrence and malignant transformation of oral leukoplakia in female patients. Among the female patients, clinicians should pay more attention to large-sized and non-homogeneous leukoplakia, and postoperative recurrent lesions.

Highlights

Oral cancers are the sixth most common malignancy across the globe, and oral squamous cell carcinoma (OSCC) accounts for more than 90% of cases
The difference of oral habits, including cigarette smoking, alcohol drinking, and betel quid chewing, between the female and male genders were found; the prevalence of use of cigarette, alcohol, and betel quid was significantly higher in men (p < 0.0001, Table 1) and in the Cox proportional regression analysis, betel quid chewing (p = 0.03, hazard ratio (HR) 10.90, confidence intervals (CIs) 95% 1.25–94.79) was a significant prognostic factor related to malignant transformation in male patients but not in the female patients
We especially identified female patients as the subject of the research, hoping to find out something more about the female patients with oral leukoplakia (OL), who are the minority in this field

Summary

Introduction

Oral cancers are the sixth most common malignancy across the globe, and oral squamous cell carcinoma (OSCC) accounts for more than 90% of cases. OSCC is believed to be preceded by oral potentially malignant disorders (OPMDs), which are oral mucosa lesions with an increased risk of development of squamous cell carcinoma [3,4]. Area of oral leukoplakia was the risk factor related to recurrence (p < 0.05). Clinical morphology and postoperative recurrence were the risk factors related to malignant transformation (p < 0.05). Conclusions: In comparison with male patients, there was no significant difference of the postoperative recurrence and malignant transformation of oral leukoplakia in female patients. Clinicians should pay more attention to large-sized and non-homogeneous leukoplakia, and postoperative recurrent lesions

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Discussion

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