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Recurrence in Oral Leukoplakia: A Systematic Review and Meta-analysis.

B P Bhattarai1, A K Singh2, R P Singh3

  • 1Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.

Journal of Dental Research
|September 18, 2024
PubMed
Summary
This summary is machine-generated.

Oral leukoplakia (OL) management is difficult due to recurrence and malignant transformation (MT) risks. Laser surgery, particularly excision and vaporization, shows promise in reducing OL recurrence and subsequent MT risk.

Keywords:
evidence-based practicelaser therapymalignant transformationoral potentially malignant disordersrisk factorssurgical excision

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Area of Science:

  • Oral Medicine
  • Oncology
  • Surgical Oncology

Background:

  • Oral leukoplakia (OL) presents significant management challenges due to high recurrence rates and potential for malignant transformation (MT).
  • Recurrent OL demonstrates a substantially elevated risk of MT compared to non-recurrent lesions.

Purpose of the Study:

  • To conduct a meta-analysis investigating the association between OL recurrence and various surgical techniques.
  • To identify clinicopathological factors influencing OL recurrence and MT risk.

Main Methods:

  • Systematic electronic searches of EMBASE, PubMed, Scopus, and Web of Science for studies on OL recurrence post-surgery.
  • Pooled proportion estimation of OL recurrence, with subgroup and meta-regression analyses on surgical techniques and clinicopathological factors.
  • Network meta-analysis to compare surgical modalities for minimizing OL recurrence.

Main Results:

  • A pooled recurrence proportion of 22% was observed across 80 studies (7,614 samples).
  • Laser-based surgeries, especially the combination of laser excision and vaporization, yielded lower recurrence rates compared to other methods.
  • Factors associated with higher recurrence include retromolar/multiple sites, nonhomogeneous type, older age, female sex, inadequate margins, retrospective data, and betel quid use.

Conclusions:

  • The combination of laser excision and vaporization may be an optimal surgical approach to reduce oral leukoplakia recurrence.
  • Oral leukoplakia in older patients, females, and nonhomogeneous lesions require vigilant monitoring post-surgery due to increased recurrence risks.