Oral Leukoplakia Follow-up
- Author: Christopher M Harris, MD, DMD; Chief Editor: Arlen D Meyers, MD, MBA more...
Further Outpatient Care
Care includes monitoring the efficacy of surgical or systemic treatment with clinical observation.
Further Inpatient Care
Oral leukoplakia (OL) is managed exclusively in an outpatient setting.
If etiologic factors can be determined, avoidance of these factors is recommended.
Approximately 10% of patients who develop OL have invasive carcinoma in the lesion (6%) or will develop carcinoma (4%). Despite excision, small dysplastic lesions can be followed by multiple carcinomas and a fatal outcome. In addition, some dysplastic OL lesions may have a worse prognosis than isolated carcinomas without leukoplakia. However, the fact that many dysplastic OL lesions can regress spontaneously shows that the behavior of dysplastic lesions is unpredictable and that no reliable management protocol has been determined. Prolonged and close follow-up care is essential, but the prognosis may still be poor.
See the list below:
- Patients must be aware that lesions may recur. They should be able to monitor the lesions and report any changes. They should maintain excellent oral hygiene.
Liu W, Shi LJ, Wu L, Feng JQ, Yang X, Li J, et al. Oral cancer development in patients with leukoplakia--clinicopathological factors affecting outcome. PLoS One. 2012. 7(4):e34773. [Medline]. [Full Text].
Brouns E, Baart J, Karagozoglu K, Aartman I, Bloemena E, van der Waal I. Malignant transformation of oral leukoplakia in a well-defined cohort of 144 patients. Oral Dis. 2013 Mar 6. [Medline].
Fan JH, Wang JB, Qu CX, et al. Association between oral leukoplakia and upper gastrointestinal cancers: a 28-year follow-up study in the Linxian General Population Trial. Oral Oncol. 2014 Oct. 50(10):971-5. [Medline]. [Full Text].
Pathology & Genetics. Head and Neck Tumours. World Health Organization. World Health Organization of Tumours. In: Barnes L, Eveson JW, Reichart P, Sidransky D, eds. Lyon: International Agency for Research of Cancer (IARC) IARC Press; 2005. 177-179.
Yang SW, Lee YS, Chang LC, Hwang CC, Luo CM, Chen TA. Use of endoscopy with narrow-band imaging system in evaluating oral leukoplakia. Head Neck. 2011 Nov 3. [Medline].
Greenspan D, Jordan RC. The white lesion that kills--aneuploid dysplastic oral leukoplakia. N Engl J Med. 2004 Apr 1. 350(14):1382-4. [Medline].
Sudbø J, Lippman SM, Lee JJ, Mao L, Kildal W, Sudbø A. The influence of resection and aneuploidy on mortality in oral leukoplakia. N Engl J Med. 2004 Apr 1. 350(14):1405-13. [Medline].
von Zeidler SV, de Souza Botelho T, Mendonca EF, et al. E-cadherin as a potential biomarker of malignant transformation in oral leukoplakia: a retrospective cohort study. BMC Cancer. 2014 Dec 17. 14:972. [Medline]. [Full Text].
Jeong WJ, Paik JH, Cho SW, Sung MW, Kim KH, Ahn SH. Excisional biopsy for management of lateral tongue leukoplakia. J Oral Pathol Med. 2011 Nov 12. [Medline].
Lin HP, Chen HM, Cheng SJ, Yu CH, Chiang CP. Cryogun cryotherapy for oral leukoplakia. Head Neck. 2011 Nov 15. [Medline].
Lippman SM, Batsakis JG, Toth BB, Weber RS, Lee JJ, Martin JW. Comparison of low-dose isotretinoin with beta carotene to prevent oral carcinogenesis. N Engl J Med. 1993 Jan 7. 328(1):15-20. [Medline].
Garewal HS, Katz RV, Meyskens F, Pitcock J, Morse D, Friedman S. Beta-carotene produces sustained remissions in patients with oral leukoplakia: results of a multicenter prospective trial. Arch Otolaryngol Head Neck Surg. 1999 Dec. 125(12):1305-10. [Medline].
Einhorn J, Wersall J. Incidence of oral carcinoma in patients with leukoplakia of the oral mucosa. Cancer. 1967 Dec. 20(12):2189-93. [Medline].
Cawson RA, Odell EW. Essentials of Oral Pathology and Oral Medicine. 6th ed. New York, NY: Churchill Livingstone. 1998.
Cawson RA, Speight P, Binnie WH, Wright J, eds. Luca's Pathology of Tumors of the Oral Tissues. 5th ed. New York, NY: Churchill Livingstone. 1998.
Eveson JW. Oral premalignancy. Cancer Surv. 1983. 2:403-424.
Haya-Fernández MC, Bagán JV, Murillo-Cortés J, Poveda-Roda R, Calabuig C. The prevalence of oral leukoplakia in 138 patients with oral squamous cell carcinoma. Oral Dis. 2004 Nov. 10(6):346-8. [Medline].
Kramer IR, El-Labban N, Lee KW. The clinical features and risk of malignant transformation in sublingual keratosis. Br Dent J. 1978 Mar 21. 144(6):171-80. [Medline].
Laskaris G. Color Atlas of Oral Diseases in Children and Adolescents. New York, NY: Thieme Medical. 2000.
Mincer HH, Coleman SA, Hopkins KP. Observations on the clinical characteristics of oral lesions showing histologic epithelial dysplasia. Oral Surg Oral Med Oral Pathol. 1972 Mar. 33(3):389-99. [Medline].
Pindborg JJ, Roed-Peterson B, Renstrup G. Role of smoking in floor of the mouth leukoplakias. J Oral Pathol. 1972. 1(1):22-9. [Medline].
Shafer WG, Hine MK, Levy BM, eds. A Textbook of Oral Pathology. 4th ed. Philadelphia, Pa: WB Saunders. 1983.
Silverman S Jr, Gorsky M, Lozada F. Oral leukoplakia and malignant transformation. A follow-up study of 257 patients. Cancer. 1984 Feb 1. 53(3):563-8. [Medline].
Silverman S, Bhargava K, Smith LW, Malaowalla AM. Malignant transformation and natural history of oral leukoplakia in 57,518 industrial workers of Gujarat, India. Cancer. 1976 Oct. 38(4):1790-5. [Medline].
Warnakulasuriya S, Johnson NW, van der Waal I. Nomenclature and classification of potentially malignant disorders of the oral mucosa. J Oral Pathol Med. 2007. 36:575-580.