Longitudinal Analysis of Oral Potentially Malignant Disorder Conversion to Malignancy

Area of Science:

• Oral medicine
• Oncology
• Public health surveillance

Background:

• Oral potentially malignant disorders (OPMDs) are conditions with the potential to develop into oral malignancies.
• A long-standing OPMD surveillance program exists, with recent advancements enabling analysis of electronic health records (EHRs).

Purpose of the Study:

• To analyze malignant conversion rates in OPMDs using EHR data.
• To assess the time course and frequency of malignant transformations in a large patient cohort.

Main Methods:

• Queried EHR data using International Classification of Disease (ICD) 9 and 10 codes for OPMDs.
• Cross-referenced OPMD patient charts with codes for oral and oropharyngeal cancers.
• Assessed the temporal patterns and rates of malignant conversion.

Main Results:

• Of 1535 eligible patients, 72 (4.69%) experienced malignant conversion.
• Conversions occurred both before 5 years (3.58%) and after 5 years (1.11%) of surveillance.
• Leukoplakia and oral lichen planus (OLP) were common precursors, but other oral lesions also converted; tongue cancers were most frequent.

Conclusions:

• Malignant conversion rates align with existing literature, highlighting the variability in OPMD progression.
• The EHR data set allows for ongoing, long-term surveillance to identify significant malignant transformations.
• The occurrence of late-stage conversions indicates that OPMDs may necessitate extended surveillance periods, similar to other cancers.