Risk of Malignant Transformation in 3173 Subjects with Histopathologically Confirmed Oral Lichen Planus: A 33-Year Cohort Study in Northern Italy.

Paolo G Arduino,Alessandro Magliano,Alessandra Macciotta,Dora Karimi,Alessio Gambino,Davide Conrotto,Roberto Broccoletti,Marco Carrozzo,Mario Carbone

doi:10.3390/cancers13225740

Paolo G Arduino, Alessandro Magliano + Show 7 more

Open Access

https://doi.org/10.3390/cancers13225740

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Journal: Cancers	Publication Date: Nov 16, 2021
Citations: 20	License type: CC BY 4.0

Affiliation: University of Turin, Newcastle University

Abstract

Simple SummaryUp to 1–4% of OLP patients could develop oral cancer, and identifying factors that could help in early detection could be extremely useful. The aim of our cohort study was to assess the clinical characteristics of one of the biggest populations ever reported with a histologically confirmed diagnosis of OLP. We identified that OLP patients who developed oral cancer usually underwent less frequent periodical follow-up visits, and older age increased the risk of death. As a significant number of OLP patients have a risk of malignant transformation, there is a critical need to review these patients preferentially, by trained clinicians, at least once a year, possibly for a lifetime.Background: Oral lichen planus (OLP) is considered an oral potentially malignant disorder. The aim of our study was to estimate the risk for oral cancer in patients diagnosed with OLP. Methods: A population-based cohort study between January 1988 and December 2020 at one hospital in Northern Italy was performed. The primary endpoint of the study was that of the histopathological diagnosis of oral cancer during the follow-up period. Results: The study population comprised 3173 patients. During the follow-up period, 32 men and 50 women developed an oral squamous cell carcinoma (2.58%), with a mean time of 103.61 months after the initial diagnosis of OLP, and 21 patients died because of oral cancer. Almost half of the deceased patients had the last follow-up visit before cancer diagnosis in a period of more than 12 months. Older age, having a red form of OLP and fewer sites of involvement, increased the risk of having cancer, while age and no treatment increased the risk of death. Conclusion: This is the largest group of OLP patients with such a long follow up ever reported. Due to the increased risk of having a malignant transformation, especially in elderly subjects, OLP patients should be regularly followed up, particularly in the Northern Italian population.

Highlights

Oral lichen planus (OLP) is a potentially malignant, chronic inflammatory disease, affecting nearly 2% of the population and causing a variety of oral lesions [1,2,3]
We were able to initially show that OLP patients had a significantly increased risk of oral squamous cell carcinoma (OSCC), and HCV infection apparently increased proportionally this risk
The present study, reporting the largest cohort of patients with OLP followed up for a period of 33 years, found that the malignant transformation occurred in a mean time of 103.61 months after the initial diagnosis of OLP; such a long follow up has rarely been documented

Summary

Introduction

Oral lichen planus (OLP) is a potentially malignant, chronic inflammatory disease, affecting nearly 2% of the population and causing a variety of oral lesions [1,2,3]. During the 1990s, data reported from our group described a prevalence of HCV antibodies in OLP patients (27.1%) as significantly higher than in control cases (4.3%), but in the last decade, we reported a smaller overall prevalence (2.5%) of anti-HCV-positive patients [8]. This could be related to an unswerving decrease in the HCV prevalence reported in European countries in the last decade, indicating that the epidemiology of HCV has distinctly changed.

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