Clinical predictors of malignant transformation and recurrence in oral potentially malignant disorders: A systematic review and meta-analysis

Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Nov;134(5):573-587. doi: 10.1016/j.oooo.2022.07.006. Epub 2022 Jul 21.

Abstract

Objective: We performed a systematic review dedicated to pooling evidence for the associations of clinical features with malignant transformation (MT) and recurrence of 3 oral potentially malignant disorders (OPMDs) (actinic cheilitis [AC], oral leukoplakia [OL], and proliferative verrucous leukoplakia [PVL]).

Study design: We selected studies that included clinical features and risk factors (age, sex, site, size, appearance, alcohol intake, tobacco use, and sun exposure) of OL, PVL, and AC associated with recurrence and/or MT.

Results: Based on the meta-analysis results, non-homogeneous OL appears to have a 4.53 times higher chance of recurrence after treatment. We also found 6.52 higher chances of MT of non-homogeneous OL. Another clinical feature related to higher MT chances is the location (floor of the mouth and tongue has 4.48 higher chances) and the size (OL with >200 mm2 in size has 4.10 higher chances of MT). Regarding habits, nonsmoking patients with OL have a 3.20 higher chance of MT. The only clinical feature related to higher chances of MT in patients with PVL was sex (females have a 2.50 higher chance of MT).

Conclusions: Our study showed that some clinical features may indicate greater chances of recurrence after treatment and MT of OPMD.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Cell Transformation, Neoplastic / pathology
  • Cheilitis*
  • Female
  • Humans
  • Leukoplakia, Oral / pathology
  • Precancerous Conditions*

Supplementary concepts

  • Actinic cheilitis