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Clinical and Histological Prognostic Factors of Recurrence and Malignant Transformation in a Large Series of Oral Potentially Malignant Disorders - PubMed

  • ️Sat Jan 01 2022

Clinical and Histological Prognostic Factors of Recurrence and Malignant Transformation in a Large Series of Oral Potentially Malignant Disorders

Luigi Lorini et al. Front Oncol. 2022.

Abstract

Background: Oral potentially malignant disorders (OPMDs) represent a heterogeneous set of different histological lesions, characterized by the capacity to transform in oral squamous cell carcinoma (OSCC). Despite optimal surgical treatment, approximately 20%-30% of OPMDs may evolve into OSCC. No clear clinical/histological factors are able to identify OPMDs at higher risk of malignant transformation.

Materials and methods: We considered surgically treated patients with a diagnosis of OPMDs, enrolled from 1996 to 2019 at ASST Spedali Civili of Brescia without a diagnosis of OSCC within the previous 2 years. Clinical and histological characteristics were recorded. Outcomes of interest were recurrence-free survival (RFS), defined as the time from surgery for primary OPMD to any relapse of OPMD or malignant transformation, whichever occurred first, and carcinoma-free survival (CFS), defined as the time from surgery for OPMD to malignant transformation.

Results: We retrospectively reviewed 106 OPMDs cases. Median age at first diagnosis was 64 years old (IQR = 18.75); female patients comprise 51.9% of the cases. During a median follow-up of 30.5 months (IQR = 44), in 23.5% of patients, malignant transformation occurred. RFS at 1, 5, and 10 years was 92.4%, 60.9%, and 43.2%, respectively. Female sex and history of previous OSCC were independent risk factors for RFS. CFS at 1, 5, and 10 years of follow-up was 97.1%, 75.9%, and 64.4%, respectively. Previous OSCC was an independent risk factor for CFS.

Conclusions: In this large series of OPMDs, only previous diagnosis of OSCC was a prognostic factor for further OSCC occurrence. Given the lack of additional clinical/pathological prognostic factors, we advocate further studies into molecular characterization of OPMDs to better stratify the risk of malignant transformation.

Keywords: head and neck squamous cell carcinoma (HNSCC); oral carcinoma risk factors; oral potentially malignant disease; oral squamous cell carcinoma (OSCC); prevention of malignant transformation.

Copyright © 2022 Lorini, Tomasoni, Gurizzan, Magri, Facchetti, Battocchio, Romani, Ravanelli, Oberti, Bozzola, Bardellini, Paderno, Mattavelli, Lombardi, Grammatica, Deganello, Facchetti, Calza, Majorana, Piazza and Bossi.

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Conflict of interest statement

PB declares advisory board participation or conference honoraria from Merck, Sanofi-Regeneron, Merck Sharp & Dohme, Sun Pharma, Angelini, Molteni, Bristol-Myers Squibb, GSK, and Nestlè. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1

(A) Recurrence-free survival, (B) carcinoma-free survival of the whole population, (C) carcinoma-free survival of the population without a history of previous OSCC. Survival curves are reported with relative tables of patients at risk.

Figure 2
Figure 2

Recurrence-free survival curves with relative tables of patients at risk according to (A) sex and (B) history of previous OSCC.

Figure 3
Figure 3

Carcinoma-free survival curves with relative tables of patients (whole population) at risk according to (A) sex and (B) history of previous OSCC.

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