Thomson PJ et al. – Potential risk of developing squamous carcinoma from an orally potential malignant disorder is variable and unpredictable for clinicians through the current histopathological diagnoses, dysplasia grading and targeted intervention for ‘high risk’ lesions. Though, same–site transformation into squamous carcinoma could be diagnosed early through modern histopathological analysis, long–term risk of developing cancer at a new–site poses a significant challenge in treating patients with potentially malignant disorder.

Methods

• Detailed, retrospective clinico–pathological analysis of potentially malignant lesions undergoing malignant transformation on a cohort of 590 patients treated by interventional laser surgery with a mean age of 7.3 years
• All patients of the cohort had potentially malignant lesions undergoing malignant transformation

Results

• About 16.8% of patients developed cancer: 12% seen ‘unexpectedly’ upon excision and 4.8% progressing to malignancy at a median of 87.3 months post–surgery.Also 32.1% developed cancer at the same precursor site, 77.7% on the ventro–lateral tongue and floor of mouth and 10.7% were micro–invasive.
• Cancers progressing towards malignancy occurred in 4.8% of patients, with erythroleukoplakia being a significant predictor of malignancy
• Majority (67.9%) of the progressive cancers arose at new sites
• Nine patients with progressive cancers died of a metastatic disease whereas a significant proportion remained disease free