Abstract
BackgroundOral cancer is a public health issue worldwide. Oral potentially malignant disorders (OMPDs) are lesions of the oral mucosa that are predisposed to malignant transformation. The mainstay of OMPDs treatment around the world is now the carbon dioxide (CO2) laser but the reported recurrence and malignant transformation rates vary widely in the literature. We aimed to estimate the recurrence and the malignant transformation rates of OPMDs treated with CO2 laser at the University Hospital of Bordeaux, in France, from 2010 to 2014, and to identify associated factors with recurrence or malignant transformation.Material and MethodsWe conducted a retrospective study in patients with a minimum follow-up of 12 months. Collected variables included characteristics of the patients (gender, age, alcohol and tobacco consumption, previous diagnosis of graft-versus-host disease, previous treatments for OPMD or for upper aerodigestive tract cancers and human immunodeficiency virus infection), characteristics of the lesions (form, colour, size, location, degree of dysplasia), laser treatment outcome (complications, recurrence, malignant transformation).ResultsTwenty-five patients were included. Mean follow-up was 28.9 months. Recurrence was observed in 11 patients (44%). Annual recurrence rate was 18.3% and annual malignant transformation rate was 1.7%. Hyperplasia without dysplasia was the only factor found to be statistically associated with recurrence.ConclusionsOur results suggest that OMPDs treated by CO2 laser vaporization have high recurrence rates, particularly those presenting hyperplasia. A standardized definition of recurrence would be necessary for inter-study comparisons. Long-term follow-up is recommended in order to detect and treat squamous cell carcinoma in its early stages. Key words:CO2 lasers, precancerous conditions, malignant transformation, oral cancer, recurrence.
Highlights
Cancer is becoming the first cause of premature deaths among noncommunicable diseases according the World Health Organization (WHO)
Hyperplasia without dysplasia was the only factor found to be statistically associated with recurrence
Our results suggest that OMPDs treated by CO2 laser vaporization have high recurrence rates, those presenting hyperplasia
Summary
Cancer is becoming the first cause of premature deaths among noncommunicable diseases according the World Health Organization (WHO). The most common OMPD in France include leukoplakia (homogeneous leukoplakia, nonhomogeneous leukoplakia and proliferative verrucous leukoplakia (PVL)), lichen planus, lichenoid dysplasia and actinic cheilitis (Table 1) (4-10) Standard care of these lesions are surgical removal of the lesion (cold-knife, laser excision and vaporization, cryosurgery, photodynamic therapy), medical treatment (topical or systemic), cessation of risk activities (smoking and alcohol) and surveillance (3). The objective of the present study was to estimate the recurrence and the malignant transformation rates of OPMDs treated with CO2 laser at the University Hospital of Bordeaux, in France, from 2010 to 2014, and to identify associated factors with recurrence or malignant transformation. The mainstay of OMPDs treatment around the world is the carbon dioxide (CO2) laser but the reported recurrence and malignant transformation rates vary widely in the literature. We aimed to estimate the recurrence and the malignant transformation rates of OPMDs treated with CO2 laser at the University Hospital of Bordeaux, in France, from 2010 to 2014, and to identify associated factors with recurrence or malignant transformation
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