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Potentially malignant disorders of the oral cavity and oral dysplasia: A systematic review and meta-analysis of malignant transformation rate by subtype

Head & Neck Jan 07, 2020

Iocca O, Sollecito TP, Alawi F, et al. - Since potentially malignant disorders of the oral cavity (OPMD) were a heterogeneous group of lesions [leukoplakia (LE), lichen planus (LP), oral lichenoid lesions (OLL), oral erythroplakia (OE), oral submucous fibrosis (OSF), and proliferative verrucous leukoplakia (PVL)] correlated with a variable risk of malignant transformation (MT) to invasive cancer, researchers conducted this systematic review and meta-analysis to define the MT rate of OPMDs and the risk of development into cancer of mild compared with moderate/severe oral dysplasia in order to implement adequate follow-up strategies and treatment decisions. For the analysis, 92 studies were involved. The overall MT rate was 7.9% in all OPMD groups. The MT rates for the specific OPMD subgroups were as follows: LP 1.4%, LE 9.5, OLL 3.8%, OSF 5.2%, OE 33.1%, and PVL 49.5%. OPMDs and oral dysplasia are relatively common disorders that are encountered in their daily practice by general practitioners, head and neck and oral medicine specialists. The analysis confirms these lesions' significant MT risk, albeit variable among the subgroups. Moderate/severe dysplasia holds a much higher risk than mild dysplasia for cancer evolution. It is important to raise awareness of these conditions' MT rates in public health, while effective communication with the patient is of utmost importance at the same time. This would help to reduce the transformation of these oral disorders into invasive cancer, together with stringent follow-up measures and effective care strategies.
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