The value of regular follow-up of oral leukoplakia for early detection of malignant transformation

Ilkay Evren; Ahmad M Najim; Jos B Poell; Elisabeth R Brouns; Leon J Wils; Laura A N Peferoen; Ruud H Brakenhoff; Elisabeth Bloemena; Erik H van der Meij; Jan G A M de Visscher

doi:10.1111/odi.14797

The value of regular follow-up of oral leukoplakia for early detection of malignant transformation

Oral Dis. 2023 Nov 7. doi: 10.1111/odi.14797. Online ahead of print.

Authors

Ilkay Evren^{1

2}, Ahmad M Najim^{1

2}, Jos B Poell^{3

4}, Elisabeth R Brouns^{1

2}, Leon J Wils^{1

2

3

4}, Laura A N Peferoen⁵, Ruud H Brakenhoff^{3

4}, Elisabeth Bloemena^{1

2

5}, Erik H van der Meij^{1

2}, Jan G A M de Visscher^{1

2}

Affiliations

¹ Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
² Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
³ Department of Otolaryngology/Head and Neck Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
⁴ Cancer Centre Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.
⁵ Department of Pathology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

PMID: 37936517
DOI: 10.1111/odi.14797

Abstract

Objectives: Evaluate whether regular follow-up of oral leukoplakia (OL) resulted in early detection of malignant transformation (MT).

Method: Two hundred and twenty-two consecutive patients with OL (147 females, 75 males); median follow-up period of 64 months (range: 12-300). Three groups were distinguished: group A (n = 92) follow-up at the hospital; group B (n = 84) follow-up by their dentist; group C (n = 46) lost to follow-up.

Results: OLs in group B compared to group A, were smaller in size (<2 cm; p < 0.001), showed more hyperkeratosis (p < 0.001) and less moderate/severe dysplasia (p < 0.001). MT occurred in 45 (20%) patients: 32 (35%) in group A, five (6%) in group B and eight (17%) in group C. There was no significant difference in clinical tumour size between group A (median: 15 mm, range: 1-40) and group B (median: 10 mm, range: 3-25; p = 0.496). Tumour size was smaller for patients in groups A and B (median: 10 mm, range 1-40) compared to group C (median: 33 mm, range: 3-100; p = 0.003). There was a positive correlation between tumour size and interval between the last visit in all patients (p = 0.022).

Conclusion: Regular follow-up of OL resulted in early detection of MT. If properly selected, follow-up of OL performed by the dentist seems feasible.

Keywords: early detection of cancer; oral cancer; oral epithelial dysplasia; oral leukoplakia; oral potentially malignant disorder; oral squamous cell carcinoma.