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Malignant Transformation Rate of Oral Premalignant Disorders: A Large Database Analysis.

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Oral leukoplakia (OL), oral lichen planus (OLP), and oral submucous fibrosis (OSF) have higher malignant transformation rates to oral squamous cell carcinoma (OSCC) than previously thought. These findings highlight the critical need for vigilant monitoring and timely intervention for oral premalignant disorders (OPMD).

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Area of Science:

  • Oral pathology
  • Oncology
  • Public health

Background:

  • Oral leukoplakia (OL), oral lichen planus (OLP), and oral submucous fibrosis (OSF) are recognized precancerous oral premalignant disorders (OPMD).
  • Previous estimates of malignant transformation rates to oral squamous cell carcinoma (OSCC) are based on limited data.
  • This study provides the largest analysis to date on OPMD malignant transformation rates.

Purpose of the Study:

  • To determine the 5-year malignant transformation rates of OL, OLP, and OSF to OSCC.
  • To compare these rates with a control cohort.
  • To analyze treatment pathways and survival outcomes for patients with OPMD.

Main Methods:

  • Retrospective cohort study utilizing the TriNetX database.
  • Inclusion of patients aged 18+ diagnosed with OL, OLP, or OSF between 2008-2018.
  • Analysis of 5-year follow-up data for OSCC transformation, treatment, and survival.

Main Results:

  • A total of 59,204 patients were included.
  • The 5-year malignant transformation rates were 15.6% for OL, 1.4% for OLP, and 18.6% for OSF.
  • The overall 5-year malignant transformation rate for OPMD was 6.2%, significantly higher than controls (p < 0.01).

Conclusions:

  • Malignant transformation rates for OL, OLP, and OSF are higher than previously reported.
  • Elevated transformation rates for OL and OSF necessitate close patient monitoring and prompt treatment.
  • The 5-year survival probability for patients with OPMD was 94.3%.