Proliferative verrucous leukoplakia: a follow-up study of 54 cases.
OBJECTIVE
Proliferative verrucous leukoplakia is a unique form of oral leukoplakia that has a high risk for becoming dysplastic and transforming into squamous cell carcinoma. The purpose of this review is to update patient profiles, pathogenesis, and survival.


METHODS
Fifty-four patients with proliferative verrucous leukoplakia (17 from a previous report) were followed prospectively in our clinic for a mean of 11.6 years after initial biopsy.


RESULTS
In the patient population studied, the mean age was 62 years, and women outnumbered men 4 to 1. Multiple intraoral sites were involved (mean, 2.6 per patient); the most common sites were buccal mucosa in women and tongue in men. In a mean time of 7.7 years, 70.3% of the patients developed a squamous cell carcinoma at a proliferative verrucous leukoplakia site, most frequently the gingiva and tongue. Twenty-one of the patients with proliferative verrucous leukoplakia died of proliferative verrucous leukoplakia-associated carcinoma. Only 31% of the 54 patients used tobacco in any form. Radiation did not appear to enhance surgical control.


CONCLUSIONS
Proliferative verrucous leukoplakia is a high risk precancerous lesion with a high mortality rate. Because of both the propensity for progression to dysplasia and malignancy, as well as a high recurrence rate, these patients must be treated aggressively and followed carefully.
Silverman
S
S
Division of Oral Medicine, School of Dentistry, University of California, San Francisco, USA.
Gorsky
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000209:etiology* / Q000601:surgery; D018289:Carcinoma, Verrucous / Q000209:etiology* / Q000601:surgery; D002471:Cell Transformation, Neoplastic; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007972:Leukoplakia, Oral / Q000150:complications* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000209:etiology* / Q000601:surgery; D012307:Risk Factors; D012744:Sex Ratio; D012907:Smoking / Q000009:adverse effects; D014860:Warts / Q000150:complications / Q000473:pathology