Oral Leukoplakia Follow-up

  • Author: Christopher M Harris, MD, DMD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Nov 17, 2011
 

Further Inpatient Care

Oral leukoplakia (OL) is managed exclusively in an outpatient setting.

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Further Outpatient Care

Care includes monitoring the efficacy of surgical or systemic treatment with clinical observation.

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Deterrence/Prevention

If etiologic factors can be determined, avoidance of these factors is recommended.

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Prognosis

Approximately 10% of patients who develop OL have invasive carcinoma in the lesion (6%) or will develop carcinoma (4%).[9] 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.

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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.
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Contributor Information and Disclosures
Author

Christopher M Harris, MD, DMD  Residency Program Director, Department of Oral and Maxillofacial Surgery, Maxillofacial Tumor and Reconstruction, Naval Medical Center Portsmouth

Christopher M Harris, MD, DMD is a member of the following medical societies: American Association of Oral and Maxillofacial Surgeons and American Dental Association

Disclosure: Nothing to disclose.

Specialty Editor Board

David J Terris, MD, FACS  Porubsky Professor and Chairman, Department of Otolaryngology, Medical College of Georgia

David J Terris, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American Association for the Advancement of Science, American Bronchoesophagological Association, American College of Surgeons, American Head and Neck Society, Federation of American Societies for Experimental Biology, International Association of Endocrine Surgeons, Phi Beta Kappa, Radiation Research Society, Society of University Otolaryngologists-Head and Neck Surgeons, and Triological Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Nader Sadeghi, MD, FRCSC  Professor, Otolaryngology-Head and Neck Surgery, Director of Head and Neck Surgery, George Washington University School of Medicine and Health Sciences

Nader Sadeghi, MD, FRCSC is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society, American Thyroid Association, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

References

  1. 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.

  2. 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. Nov 3 2011;[Medline].

  3. 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].

  4. 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].

  5. Jeong WJ, Paik JH, Cho SW, Sung MW, Kim KH, Ahn SH. Excisional biopsy for management of lateral tongue leukoplakia. J Oral Pathol Med. Nov 12 2011;[Medline].

  6. Lin HP, Chen HM, Cheng SJ, Yu CH, Chiang CP. Cryogun cryotherapy for oral leukoplakia. Head Neck. Nov 15 2011;[Medline].

  7. 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].

  8. 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].

  9. Einhorn J, Wersall J. Incidence of oral carcinoma in patients with leukoplakia of the oral mucosa. Cancer. Dec 1967;20(12):2189-93. [Medline].

  10. Cawson RA, Odell EW. Essentials of Oral Pathology and Oral Medicine. 6th ed. New York, NY: Churchill Livingstone;1998.

  11. 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.

  12. Eveson JW. Oral premalignancy. Cancer Surv. 1983;2:403-424.

  13. 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].

  14. 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].

  15. Laskaris G. Color Atlas of Oral Diseases in Children and Adolescents. New York, NY: Thieme Medical;2000.

  16. 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].

  17. 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].

  18. Shafer WG, Hine MK, Levy BM, eds. A Textbook of Oral Pathology. 4th ed. Philadelphia, Pa: WB Saunders;1983.

  19. 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].

  20. 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].

  21. 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.

 
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