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Updated: Feb 27, 2026
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Published on: August 9, 2024
Management of proliferative verrucous leukoplakia: Justification for a conservative approach
Scott C Borgna1, Peter T Clarke2, Andrew G Schache3,4
1Royal Brisbane and Women's Hospital Metro North Hospital and Health Service, Department of Oral and Maxillofacial Surgery, Brisbane, Queensland, Australia.
Background:
Proliferative verrucous leukoplakia (PVL) is a progressive, multifocal, exophytic form of leukoplakia with high rates of malignant transformation. The purpose of this study was to evaluate a cohort of patients with PVL in a single tertiary referral clinic.
Method:
Cases meeting accepted diagnostic criteria were reviewed with regard to their pathology, demographic characteristics, management, and outcomes. Human papillomavirus (HPV) testing was undertaken on a subset.
Results:
Almost half of the 48 patients with PVL (48%; n = 23) underwent malignant transformation after a median 23.4 months. The characteristics of this cohort were similar to those previously described, but management was notably more conservative. Conservative management of PVL was used in 92% of our patients, but the clinical outcomes seem comparable with previously described cohorts in which PVL was predominantly treated by surgical excision. All HPV testing was negative.
Conclusion:
Aggressive surgical intervention in the premalignant phase of PVL may not influence the rate of malignant transformation.
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