eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Head & Neck Surgery
Oral Leukoplakia, Idiopathic: Follow-up
Updated: Feb 7, 2008
Follow-up
Further Inpatient Care
Oral leukoplakia (OL) is managed exclusively in an outpatient setting.
Further Outpatient Care
Care includes monitoring the efficacy of surgical or systemic treatment with clinical observation.
Deterrence/Prevention
If etiologic factors can be determined, avoidance of these factors is recommended.
Prognosis
Approximately 10% of patients who develop OL have invasive carcinoma in the lesion (6%) or will develop carcinoma (4%).6 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.
Patient Education
- 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.
- For excellent patient education resources, visit eMedicine's Cancer and Tumors Center. Also, see eMedicine's patient education article Cancer of the Mouth and Throat.
Miscellaneous
Medicolegal Pitfalls
- Failure to inform patients about the malignant potential of the disease before and after treatment
- Failure to inform patients of the need for clinical follow-up care
More on Oral Leukoplakia, Idiopathic |
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Follow-up: Oral Leukoplakia, Idiopathic |
| References |
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References
Pathology & Genetics. Head and Neck Tumours. In: 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.
Greenspan D, Jordan RC. The white lesion that kills--aneuploid dysplastic oral leukoplakia. N Engl J Med. Apr 1 2004;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. Apr 1 2004;350(14):1405-13. [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. Jan 7 1993;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. Dec 1999;125(12):1305-10. [Medline].
Einhorn J, Wersall J. Incidence of oral carcinoma in patients with leukoplakia of the oral mucosa. Cancer. Dec 1967;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. Nov 2004;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. Mar 21 1978;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. Mar 1972;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. Feb 1 1984;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. Oct 1976;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.
Further Reading
Keywords
oral leukoplakia, OL, focal keratosis, hyperkeratosis, mouth cancer, leukoplakia, oral plaque, mouth plaque, idiopathic leukoplakia, idiopathic oral leukoplakia, premalignant oral lesion, premalignant mouth lesion, precancerous lesion, speckled leukoplakia, verrucous leukoplakia, homogenous leukoplakia, speckled OL, verrucous OL, homogenous OL
Follow-up: Oral Leukoplakia, Idiopathic