Potentially malignant disorders revisited—The lichenoid lesion/proliferative verrucous leukoplakia conundrum

Thomson, Peter J., Goodson, Michaela L., and Smith, Daniel R. (2018) Potentially malignant disorders revisited—The lichenoid lesion/proliferative verrucous leukoplakia conundrum. Journal of Oral Pathology and Medicine, 47 (6). pp. 557-565.

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DOI: 10.1111/jop.12716

View at Publisher Website: https://doi.org/10.1111/jop.12716

Abstract

Background: Clinically identifiable potentially malignant disorders (PMD) precede oral squamous cell carcinoma development. Oral lichenoid lesions (OLL) and proliferative verrucous leukoplakia (PVL) are specific precursor lesions believed to exhibit both treatment resistance and a high risk of malignant transformation (MT).

Methods: A retrospective review of 590 PMD patients treated in Northern England by CO2 laser surgery between 1996 and 2014 was carried out. Lesions exhibiting lichenoid or proliferative verrucous features were identified from the patient database and their clinicopathological features and outcome post-treatment determined at the study census date of 31 December 2014.

Results: One hundred and 98 patients were identified as follows: 118 OLL and 80 PVL, most frequently leukoplakia at ventrolateral tongue and floor of mouth sites, equally distributed between males and females. Most exhibited dysplasia on incision biopsy (72% OLL; 85% PVL) and were treated by laser excision rather than ablation (88.1% OLL; 86.25% PVL). OLL were more common in younger patients (OLL 57.1 year; PVL 62.25 years; P =.008) and more likely than PVL to present as erythroleukoplakia (OLL 15.3%; PVL 2.5%; P =.003). Whilst no significant difference was seen between OLL and PVL achieving disease-free status (69.5% and 65%, respectively; P =.55), this was less than the overall PMD cohort (74.2%). MT was identified in 2 OLL (1.7%) and 2 PVL (2.5%) during follow-up.

Conclusion: One-third of PMD cases showed features of OLL or PVL, probably representing a disease presentation continuum. Post-treatment disease-free status was less common in OLL and PVL, although MT was infrequent.


Item ID:	68448
Item Type:	Article (Research - C1)
ISSN:	1600-0714
Keywords:	clinical outcome, oral lichenoid lesions, potentially malignant disorders, proliferative verrucous leukoplakia
Copyright Information:	© 2018 John Wiley & Sons A/S.
Date Deposited:	01 Aug 2022 01:46
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3203 Dentistry > 320305 Oral and maxillofacial surgery @ 50% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3211 Oncology and carcinogenesis > 321102 Cancer diagnosis @ 50%
SEO Codes:	20 HEALTH > 2001 Clinical health > 200101 Diagnosis of human diseases and conditions @ 50% 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 50%
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