Treatment Outcome of Dysplastic Oral Leukoplakia with Carbon Dioxide Laser—Emphasis on the Factors Affecting Recurrence

Abstract

To evaluate the associated factors of recurrence in patients who received laser surgery for dysplastic oral leukoplakia. Clinicopathologic data of patients and their human papillomavirus genome status were used to analyze their association with recurrence after surgery. Of 114 enrolled patients, 90 were men and 24 were women with an average age of 49.7 ± 12.2 years, and follow-up was 1.75 to 9.1 years (mean, 3.4 ± 1.3 years). Recurrence after surgery occurred in 20 patients (17.5%). Thirteen patients had malignant transformation (11.4%). Twenty patients showed positivity for human papillomavirus (21.7%). Univariate analysis showed that patients who did not quit smoking or chewing betel quid after surgical treatment or whose oral leukoplakia took the form of widespread multiple-focus lesions, nonhomogeneous leukoplakia, and higher-grade dysplasia tended to have recurrence. Among these significant risk factors, continuous smoking after surgical treatment (odds ratio, 3.82) and widespread multiple-focus lesions (odds ratio, 4.54) were the independent prognostic factors for recurrence using multivariate logistic regression analysis. Those who did not quit chewing betel quid or smoking cigarettes were 19.8 or 9.7 times, respectively, more likely to develop recurrence than those who did quit. This study suggests that continuous smoking after surgical treatment and widespread multiple-focus lesions are the prognostic indicators for recurrence after laser surgery. Changes in oral habits can be of great importance to the outcome of laser surgery of dysplastic oral leukoplakia.