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.

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%).^[22]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

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.
For excellent patient education resources, visit eMedicineHealth's Cancer Center. Also, see eMedicineHealth's patient education article Cancer of the Mouth and Throat.

Mohammed F, Fairozekhan AT. Oral Leukoplakia. StatPearls. 2020 Jan. [QxMD MEDLINE Link]. [Full Text].
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. [QxMD MEDLINE Link]. [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. [QxMD MEDLINE Link].
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.
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. [QxMD MEDLINE Link].
Lin HP, Chen HM, Cheng SJ, Yu CH, Chiang CP. Cryogun cryotherapy for oral leukoplakia. Head Neck. 2011 Nov 15. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link]. [Full Text].
Rubert A, Bagan L, Bagan JV. Oral leukoplakia, a clinical-histopathological study in 412 patients. J Clin Exp Dent. 2020 Jun. 12 (6):e540-6. [QxMD MEDLINE Link]. [Full Text].
Paglioni MP, Khurram SA, Ruiz BII, et al. Clinical predictors of malignant transformation and recurrence in oral potentially malignant disorders: A systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Nov. 134 (5):573-87. [QxMD MEDLINE Link].
Roza ALOC, Kowalski LP, William WN Jr, et al. Oral leukoplakia and erythroplakia in young patients: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Jan. 131 (1):73-84. [QxMD MEDLINE Link].
Lyu MY, Guo YS, Li S, Yang D, Hua H. Hospital-based epidemiological and clinical characterisation of the malignant transformation of oral leukoplakia in a Chinese population. Int Dent J. 2017 Mar 9. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Greenspan D, Jordan RC. The white lesion that kills--aneuploid dysplastic oral leukoplakia. N Engl J Med. 2004 Apr 1. 350(14):1382-4. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Sakata J, Yoshida R, Matsuoka Y, et al. Predictive value of the combination of SMAD4 expression and lymphocyte infiltration in malignant transformation of oral leukoplakia. Cancer Med. 2017 Mar 3. [QxMD MEDLINE Link]. [Full Text].
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. [QxMD MEDLINE Link]. [Full Text].
Habiba U, Hida K, Kitamura T, et al. ALDH1 and podoplanin expression patterns predict the risk of malignant transformation in oral leukoplakia. Oncol Lett. 2017 Jan. 13 (1):321-8. [QxMD MEDLINE Link]. [Full Text].
Grochau KJ, Safi AF, Drebber U, Grandoch A, Zöller JE, Kreppel M. Podoplanin expression in oral leukoplakia─a prospective study. J Craniomaxillofac Surg. 2019 Mar. 47 (3):505-9. [QxMD MEDLINE Link].
Gissi DB, Gabusi A, Tarsitano A, Luccarini L, Morandi L, Montebugnoli L. Podoplanin expression as a predictive marker of dysplasia in oral leukoplakia. J Craniomaxillofac Surg. 2018 May. 46 (5):759-64. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Einhorn J, Wersall J. Incidence of oral carcinoma in patients with leukoplakia of the oral mucosa. Cancer. 1967 Dec. 20(12):2189-93. [QxMD MEDLINE Link].

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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, American Dental Association

Disclosure: Nothing to disclose.

Specialty Editor Board

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

Disclosure: Received salary from Medscape for employment. for: Medscape.

Nader Sadeghi, MD, FRCSC Professor and Chairman, Department of Otolaryngology-Head and Neck Surgery, McGill University Faculty of Medicine; Chief Otolaryngologist, MUHC; Director, McGill Head and Neck Cancer Program, Royal Victoria Hospital, Canada

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, Royal College of Physicians and Surgeons of Canada

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Merck.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, 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, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan; Ryte; Neosoma; MI10<br/>Received income in an amount equal to or greater than $250 from: Neosoma; Cyberionix (CYBX)<br/>Received ownership interest from Cerescan for consulting for: Neosoma, MI10.

Additional Contributors

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

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, Triological Society

Disclosure: Nothing to disclose.