Malignant transformation rate of oral leukoplakia in an Australian population

Kate Shearston, Behrooz Fateh, Shixiong Tai, Dzikamai Hove, Camile S. Farah

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: Oral leukoplakia (OLK) is one of the most common oral potentially malignant lesions (OPMD) and is reported to undergo malignant transformation (MT) to oral squamous cell carcinoma (OSCC) at rates of between 0.13% and 34%. This study seeks to determine the proportion of OLK lesions that develop into OSCC in an Australian population and assess the risk factors associated with this transformation. Methods: The study is a retrospective audit of patients from a private oral medicine clinic, diagnosed with OLK using clinical and histopathological data between 2006 and 2014. Patients were cross-matched with Cancer Registry data for OSCC, and the rate and time to malignant transformation were determined. Results: Oral leukoplakia patients with histopathological confirmation of their lesions underwent MT at a rate of 1.49% (3/202), with an average time to MT (TMT) of 5.2 years. When patients without histopathological confirmation were assessed, the MT rate was slightly less (1.30%; 4.9 years TMT). Patients who transformed were more likely to be older females with a history of smoking and alcohol use, with OLK present on the tongue or floor of mouth. The rate of oral epithelial dysplasia (OED) in the transformed group was surprisingly low (one third). Conclusions: Oral leukoplakia is at a moderate risk of malignant transformation which can be reduced by careful management. Current tools for identifying high-risk OLK, including histopathological assessment of OED, may not capture all lesions that undergo MT and should be supplemented by unbiased molecular biomarkers.

Original languageEnglish
JournalJournal Of Oral Pathology and Medicine
DOIs
Publication statusE-pub ahead of print - 7 Jun 2019

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Oral Leukoplakia
Population
Squamous Cell Carcinoma
Mouth Floor
Oral Medicine
Tongue
Registries
Biomarkers
Smoking
Alcohols

Cite this

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title = "Malignant transformation rate of oral leukoplakia in an Australian population",
abstract = "Objectives: Oral leukoplakia (OLK) is one of the most common oral potentially malignant lesions (OPMD) and is reported to undergo malignant transformation (MT) to oral squamous cell carcinoma (OSCC) at rates of between 0.13{\%} and 34{\%}. This study seeks to determine the proportion of OLK lesions that develop into OSCC in an Australian population and assess the risk factors associated with this transformation. Methods: The study is a retrospective audit of patients from a private oral medicine clinic, diagnosed with OLK using clinical and histopathological data between 2006 and 2014. Patients were cross-matched with Cancer Registry data for OSCC, and the rate and time to malignant transformation were determined. Results: Oral leukoplakia patients with histopathological confirmation of their lesions underwent MT at a rate of 1.49{\%} (3/202), with an average time to MT (TMT) of 5.2 years. When patients without histopathological confirmation were assessed, the MT rate was slightly less (1.30{\%}; 4.9 years TMT). Patients who transformed were more likely to be older females with a history of smoking and alcohol use, with OLK present on the tongue or floor of mouth. The rate of oral epithelial dysplasia (OED) in the transformed group was surprisingly low (one third). Conclusions: Oral leukoplakia is at a moderate risk of malignant transformation which can be reduced by careful management. Current tools for identifying high-risk OLK, including histopathological assessment of OED, may not capture all lesions that undergo MT and should be supplemented by unbiased molecular biomarkers.",
keywords = "Australia, malignant transformation, oral epithelial dysplasia, oral leukoplakia, oral squamous cell carcinoma",
author = "Kate Shearston and Behrooz Fateh and Shixiong Tai and Dzikamai Hove and Farah, {Camile S.}",
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Malignant transformation rate of oral leukoplakia in an Australian population. / Shearston, Kate; Fateh, Behrooz; Tai, Shixiong; Hove, Dzikamai; Farah, Camile S.

In: Journal Of Oral Pathology and Medicine, 07.06.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Malignant transformation rate of oral leukoplakia in an Australian population

AU - Shearston, Kate

AU - Fateh, Behrooz

AU - Tai, Shixiong

AU - Hove, Dzikamai

AU - Farah, Camile S.

PY - 2019/6/7

Y1 - 2019/6/7

N2 - Objectives: Oral leukoplakia (OLK) is one of the most common oral potentially malignant lesions (OPMD) and is reported to undergo malignant transformation (MT) to oral squamous cell carcinoma (OSCC) at rates of between 0.13% and 34%. This study seeks to determine the proportion of OLK lesions that develop into OSCC in an Australian population and assess the risk factors associated with this transformation. Methods: The study is a retrospective audit of patients from a private oral medicine clinic, diagnosed with OLK using clinical and histopathological data between 2006 and 2014. Patients were cross-matched with Cancer Registry data for OSCC, and the rate and time to malignant transformation were determined. Results: Oral leukoplakia patients with histopathological confirmation of their lesions underwent MT at a rate of 1.49% (3/202), with an average time to MT (TMT) of 5.2 years. When patients without histopathological confirmation were assessed, the MT rate was slightly less (1.30%; 4.9 years TMT). Patients who transformed were more likely to be older females with a history of smoking and alcohol use, with OLK present on the tongue or floor of mouth. The rate of oral epithelial dysplasia (OED) in the transformed group was surprisingly low (one third). Conclusions: Oral leukoplakia is at a moderate risk of malignant transformation which can be reduced by careful management. Current tools for identifying high-risk OLK, including histopathological assessment of OED, may not capture all lesions that undergo MT and should be supplemented by unbiased molecular biomarkers.

AB - Objectives: Oral leukoplakia (OLK) is one of the most common oral potentially malignant lesions (OPMD) and is reported to undergo malignant transformation (MT) to oral squamous cell carcinoma (OSCC) at rates of between 0.13% and 34%. This study seeks to determine the proportion of OLK lesions that develop into OSCC in an Australian population and assess the risk factors associated with this transformation. Methods: The study is a retrospective audit of patients from a private oral medicine clinic, diagnosed with OLK using clinical and histopathological data between 2006 and 2014. Patients were cross-matched with Cancer Registry data for OSCC, and the rate and time to malignant transformation were determined. Results: Oral leukoplakia patients with histopathological confirmation of their lesions underwent MT at a rate of 1.49% (3/202), with an average time to MT (TMT) of 5.2 years. When patients without histopathological confirmation were assessed, the MT rate was slightly less (1.30%; 4.9 years TMT). Patients who transformed were more likely to be older females with a history of smoking and alcohol use, with OLK present on the tongue or floor of mouth. The rate of oral epithelial dysplasia (OED) in the transformed group was surprisingly low (one third). Conclusions: Oral leukoplakia is at a moderate risk of malignant transformation which can be reduced by careful management. Current tools for identifying high-risk OLK, including histopathological assessment of OED, may not capture all lesions that undergo MT and should be supplemented by unbiased molecular biomarkers.

KW - Australia

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