Treatment of oral leukoplakia ranges from watchful waiting to complete resection.
In this study, researchers from Norway assessed resection, ploidy status, and death in patients with oral leukoplakia.
The team evaluated 103 patients with diploid dysplastic oral leukoplakia, 20 patients with tetraploid lesions, and 27 patients with aneuploid lesions.
Data on cancer-specific mortality and treatment were obtained from the Cancer Registry of Norway, Statistics Norway, and from chart reviews.
The researchers found that primary oral carcinoma developed in 31% of the 150 patients with leukoplakia during a mean follow-up of 80 months. Carcinoma developed in 5 patients with diploid, 16 with tetraploid, and 26 with aneuploid leukoplakia
The team established that the margin status of the initial leukoplakia resection had no relation to the development of oral cancer.
|55% of patients who developed cancer had recurrences.|
|New England Journal of Medicine|
They also found that 55% of patients who developed cancer had recurrences. The recurrences were more frequently multiple and distant in patients with aneuploid lesions.
All the patients with cancer underwent a standard regimen of surgery and radiation, followed by chemotherapy in the 26 with recurrent cancer.
The team found that it was only the patients with aneuploid leukoplakia who died of oral cancer. They calculated that the 5-year rate of death from cancer was 72%.
Overall, aneuploidy-related first carcinomas were diagnosed at a more advanced stage than carcinomas originating from diploid or tetraploid leukoplakia. They were also more likely to be lethal regardless of stage.
Dr Jon Sudbø and colleagues concluded, "Complete resection of aneuploid leukoplakia does not reduce the high risk of aggressive carcinoma and death from oral cancer".