title: Malignant transformation of oral leukoplakia in a well-defined cohort of 144 patients.
abstract: OBJECTIVE
  Oral leukoplakia is a potentially malignant disorder of the oral mucosa. The aim of this retrospective study was to identify the factors that possibly predict malignant transformation in a well-defined cohort of patients with a long-term follow-up. All leukoplakias were staged according to a clinicopathological classification and staging system. Furthermore, a certainty factor has been used with which the diagnosis has been established.
  
  
  METHODS
  The group consisted of 144 patients. The size, presence and degree of epithelial dysplasia were incorporated into a clinicopathological classification and staging system. Initial management consisted of surgical excision, CO2 laser vaporisation or observation only. The mean follow-up period was 51.2 months (s.d. = 39.33, range 12-179 months).
  
  
  RESULTS
  In 16 of 144 patients (11%), malignant transformation occurred between 20 and 94 months (mean 57.0 months) after the first visit, the annual malignant transformation rate being approximately 2.6%. A large size of the lesion (≥ 4 cm) showed to be the only statistically significant predictor of malignant transformation (P = 0.034).
  
  
  CONCLUSIONS
  A size of ≥ 4 cm showed to be the only significant predicting factor of malignant transformation in oral leukoplakia. No other epidemiological, aetiological, clinical or histopathological parameters were of statistical significance.
authors.affiliation: Department of Oral and Maxillofacial Surgery and Oral Pathology, VU University Medical Center (VUmc)/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
authors.forename: Erea
authors.initials: E
authors.lastname: Brouns
authors.forename: Ja
authors.initials: J
authors.lastname: Baart
authors.forename: Kh
authors.initials: Kh
authors.lastname: Karagozoglu
authors.forename: Iha
authors.initials: I
authors.lastname: Aartman
authors.forename: E
authors.initials: E
authors.lastname: Bloemena
authors.forename: I
authors.initials: I
authors.lastname: van der Waal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002471:Cell Transformation, Neoplastic; D005260:Female; D006801:Humans; D007972:Leukoplakia, Oral / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D055815:Young Adult
keywords: malignant transformation; oral cancer; oral epithelial dysplasia; oral leukoplakia; potentially malignant oral disorder