title: Outcome of excision of oral erythroplakia.
abstract: Oral erythroplakia is a precancerous lesion with high malignant potential, and resection is the recommended treatment. We designed a retrospective study to analyse the outcome of treatment in patients who had operations for oral erythroplakia. A total of 84 patients (74 men and 10 women, mean (SD) age 54 (12) years, range 29-83) were enrolled. Histopathologically the diagnoses were invasive carcinoma (n=3), dysplasia/carcinoma in situ (n=61), and squamous hyperplasia (n=20), and all patients were treated by carbon dioxide laser excision. There was no postoperative malignant transformation, but invasive carcinoma found after initial excision (n=3) was treated by further radical excision. The mean (SD) follow-up period was 46 (29) months (range 1-124), The postoperative recurrent rate was 14/84 (16.7%). The area of oral erythroplakia was the only factor associated with postoperative recurrence on univariate analysis, and was also the only independent factor that predicted postoperative recurrence in multivariate logistic regression analysis. An area exceeding 80 mm2 had the best predictive value (sensitivity=0.71, specificity=0.67) with a 5.1 times increased risk (odds ratio=5.1, CI 95% 1.45 to 18.05, p=0.01) of recurrence. Laser excision is effective for oral erythroplakia that is still confined to dysplasia of any degree, with low morbidity. The area of oral erythroplakia is a predictive factor for postoperative recurrence.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC; School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC. Electronic address: sweeyang@gmail.com.
authors.forename: S W
authors.initials: SW
authors.lastname: Yang
authors.affiliation: Genomic Medicine Research Core Laboratory, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan, ROC; Department of Biotechnology, Ming Chuan University, Tao-Yuan, Taiwan, ROC.
authors.forename: Y S
authors.initials: YS
authors.lastname: Lee
authors.affiliation: School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC; Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.
authors.forename: L C
authors.initials: LC
authors.lastname: Chang
authors.affiliation: School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC; Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.
authors.forename: T Y
authors.initials: TY
authors.lastname: Hsieh
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC; School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan, ROC.
authors.forename: T A
authors.initials: TA
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D001114:Areca; D002278:Carcinoma in Situ / Q000601:surgery; D004919:Erythroplasia / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D053685:Laser Therapy / Q000379:methods; D054020:Lasers, Gas / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery*; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012907:Smoking; D016896:Treatment Outcome
keywords: Carbon dioxide laser; Carcinoma; Dysplasia; Erythroplakia; Oral mucosa