title: How should we manage oral leukoplakia?
abstract: The aim of this article is to review the management of oral leukoplakia. The topics of interest are clinical diagnosis, methods of management and their outcome, factors associated with malignant transformation, prognosis, and clinical follow-up. Global prevalence is estimated to range from 0.5 to 3.4%. The point prevalence is estimated to be 2.6% (95% CI 1.72-2.74) with a reported rate of malignant transformation ranging from 0.13 to 17.5%. Incisional biopsy with scalpel and histopathological examination of the suspicious tissue is still the gold standard for diagnosis. A number of factors such as age, type of lesion, site and size, dysplasia, and DNA content have been associated with increased risk of malignant transformation, but no single reliable biomarker has been shown to be predictive. Various non-surgical and surgical treatments have been reported, but currently there is no consensus on the most appropriate one. Randomised controlled trials for non-surgical treatment show no evidence of effective prevention of malignant transformation and recurrence. Conventional surgery has its own limitations with respect to the size and site of the lesion but laser surgery has shown some encouraging results. There is no universal consensus on the duration or interval of follow-up of patients with the condition.
authors.affiliation: Maxillofacial Department, Nothwick Park Hospital, Northwest London Hospitals NHS Trust, Harrow, Middlesex HA1 3UJ, United Kingdom. anandkumar@doctors.net.uk
authors.forename: Anand
authors.initials: A
authors.lastname: Kumar
authors.forename: Luke
authors.initials: L
authors.lastname: Cascarini
authors.forename: James A
authors.initials: JA
authors.lastname: McCaul
authors.forename: Cyrus J
authors.initials: CJ
authors.lastname: Kerawala
authors.forename: Darryl
authors.initials: D
authors.lastname: Coombes
authors.forename: Daryl
authors.initials: D
authors.lastname: Godden
authors.forename: Peter A
authors.initials: PA
authors.lastname: Brennan
mesh_terms: D002471:Cell Transformation, Neoplastic / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007972:Leukoplakia, Oral / Q000601:surgery / Q000628:therapy*; D009062:Mouth Neoplasms / Q000517:prevention & control; D011230:Precancerous Conditions / Q000601:surgery / Q000628:therapy; D012307:Risk Factors