title: Malignant transformation in 5071 southern Taiwanese patients with potentially malignant oral mucosal disorders.
abstract: BACKGROUND
  Oral cancers can be preceded by clinically evident oral potentially malignant disorders (OPMDs). The current study evaluated the rate and the time of malignant transformation in the various OPMDs in a cohort of patients from southern Taiwan. Parameters possibly indicative for malignant transformation of OPMDs, such as epidemiological and etiological factors, and clinical and histopathological features were also described.
  
  
  METHODS
  We followed-up 5071 patients with OPMDs-epithelial dysplasia with oral submucous fibrosis, epithelial dysplasia with hyperkeratosis/epithelial hyperplasia, hyperkeratosis/epithelial hyperplasia, oral submucous fibrosis, lichen planus, and verrucous hyperplasia-between 2001 and 2010 for malignant transformation.
  
  
  RESULTS
  Two hundred nineteen of these 5071 OPMD patients (202 men, 17 women; mean age: 51.25 years; range: 30-81 years) developed oral cancers (179 squamous cell carcinomas; 40 verrucous carcinomas) in the same sites as the initial lesions at least 6 months after their initial biopsies. The overall transformation rate was 4.32% (mean duration of transformation: 33.56 months; range: 6-67 months). Additionally, the mean time of malignant transformation was significantly shorter for lesions with than without epithelial dysplasia. The risk of malignant transformation was 1.89 times higher for epithelially dysplastic than non-dysplastic lesions. The anatomical site of OPMD and the presence of epithelial dysplasia were significantly associated with malignant transformation. The hazard rate ratio was 1.87 times larger for tongue lesions than for buccal lesions.
  
  
  CONCLUSIONS
  Patients with OPMDs require long-term follow up.
authors.forename: Yen-Yun
authors.initials: YY
authors.lastname: Wang
authors.forename: Yen-Hsuan
authors.initials: YH
authors.lastname: Tail
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Wang
authors.forename: Ching-Yi
authors.initials: CY
authors.lastname: Chen
authors.forename: Yu-Hsun
authors.initials: YH
authors.lastname: Kao
authors.affiliation: Division of Oral and Maxillofacial Surgery, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. k840042@gmail.com.
authors.forename: Yuk-Kwan
authors.initials: YK
authors.lastname: Chen
authors.forename: Chung-Ho
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D001114:Areca; D001706:Biopsy / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D018289:Carcinoma, Verrucous / Q000473:pathology; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005887:Gingival Neoplasms / Q000473:pathology; D006801:Humans; D006965:Hyperplasia; D007972:Leukoplakia, Oral / Q000473:pathology; D017676:Lichen Planus, Oral / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000473:pathology*; D009914:Oral Submucous Fibrosis / Q000473:pathology; D011230:Precancerous Conditions / Q000473:pathology*; D012307:Risk Factors; D012907:Smoking; D013624:Taiwan; D014062:Tongue Neoplasms / Q000473:pathology
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