The use of CO2 laser in the treatment of oral white patches: outcomes and factors affecting recurrence.
Laser therapy has been a favoured treatment regime for oral leukoplakia since the mid 1980s. There is no information in the literature regarding factors affecting outcomes in patients with oral leukoplakia. Forty-three patients (mean age 60.3+/-13.6 years) with 73 primary oral leukoplakia were assessed for outcome and factors affecting survival. Dysplastic lesions were found in the majority of patients. The male to female ratio was 1.7:1 with 74% ex- or current smokers, 27% consuming alcohol and 31% continuing to smoke after treatment. The mean observation time was 47.2+/-28.2 months (range 2-102 months). Disease-free survival was 55.4% at 3 years that dropped to 33.9% after 5 years. The malignant transformation rate was 7.3%. No significant prognostic factors were found on univariate analysis but alcohol consumption (P=0.034) and previous malignancy (P=0.018) were found to be significant prognostic indicators using multivariate analysis. Continuation to smoke approached significance (P=0.061). Similar disease-free survival and malignant transformation rates with minimal complications were found as compared to the literature. Recommendations for minimizing recurrence are presented. Long-term follow up and removal of aetiological factors, such as smoking and alcohol, are advised.
Chandu
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Oral and Maxillofacial Surgery, Austin Health, Heidelberg, Vic., Australia.
Smith
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AC
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D002245:Carbon Dioxide; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053685:Laser Therapy; D007972:Leukoplakia, Oral / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016896:Treatment Outcome
D002245:Carbon Dioxide