Abstract
BackgroundA retrospective clinical-histopathological study was made of the evolution of oral leukoplakia over time, staging the disease according to the classification of van der Waal. Material and MethodsA study was made of 412 patients with oral leukoplakia, analyzing the corresponding clinical factors and histopathological findings; assessing associations between the different clinical presentations and epithelial dysplasia; and evaluating the factors influencing malignant transformation of the lesions. ResultsClinically, homogeneous presentations were seen to predominate (n = 336, 81.6%), while histologically most of the lesions exhibited no dysplastic changes (n = 271; 65.7%). Stage 1 of the van der Waal classification was the most common presentation (n = 214; 51.9%). The lesion malignization rate was 8.3%, and the factors associated to a significantly increased malignization risk were non-homogeneous OL lesions (p=0.00), lesion location in the tongue (p=0.00), and the presence of epithelial dysplasia (p=0.00). ConclusionsIn our series of patients with oral leukoplakia, malignization was associated to the less common clinical presentations of the disease, i.e., non-homogeneous lesions, and the latter tended to exhibit high grade epithelial dysplasia. Key words:Oral leukoplakia, potentially malignant disorders, malignant transformation.
Highlights
Oral leukoplakia (OL) is the most common potentially malignant lesion of the oral mucosa [1], with an estimated prevalence of 2% in the general population
Other described etiological factors are Sanguinaria canadensis contained in toothpastes and oral rinses, infectious agents such as Candida, human papillomavirus (HPV) and bacteria, nutritional and socioeconomic factors, and certain systemic disorders [6]
Malignant transformation is considered to be more likely in women, in patients with long-evolving lesions, OL located on the tongue and/or floor of the mouth, lesions measuring over 200 mm2 in size, non-homogeneous lesions, and OL exhibiting dysplasia in the biopsy study [10]
Summary
Oral leukoplakia (OL) is the most common potentially malignant lesion of the oral mucosa [1], with an estimated prevalence of 2% in the general population. Smoking is the main established causal factor underlying these potentially malignant lesions [5,6]. It would be of interest to conduct studies involving large series of patients with OL in order to assess possible relationships among the different risk factors. In this regard, the present study was designed with the following objectives: (a) to assess possible associations between the clinical forms and the presence of epithelial dysplasia; and (b) to evaluate the evolution of the lesions after a minimum follow-up period of 5 years, and explore possible associations between the clinical forms and the presence of epithelial dysplasia and progression towards malignancy
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