Dorsal tongue versus ventrolateral tongue leukoplakia: An anatomical perspective on clinicopathological characteristics and treatment outcomes

Abstract Background Among the risks of malignant transformation of oral leukoplakia, tongue has been identified as a high-risk site. Only little information exists on the clinicopathological characteristics and treatment outcomes specific to leukoplakia of the dorsum of the tongue. The comparison of clinicopathological characteristics of the dorsal tongue and ventrolateral tongue leukoplakia is not available in the literature. The purpose of this study is to investigate the clinicopathological characteristics and treatment outcomes between dorsal and ventrolateral tongue leukoplakia. Methods The demographic data and pathological results of the patients who received carbon dioxide laser surgery for tongue leukoplakia from 2002 to 2019 were retrospectively reviewed and analyzed statistically. Results Of 144 enrolled, there were 108 males and 36 females with a mean age 52.17 ± 11.72. The follow-up time was 4.58 ± 4.53 years. Thirty patients had postoperative recurrence (20.83%). Twelve patients developed malignant transformation (8.33%). Annual transformation rate was 2.28%. In comparison of dorsal and ventrolateral tongue leukoplakia, there were no differences in the time to the development of carcinoma (2.62 ± 1.69 VS 3.98 ± 2.77 years), overall cumulative malignant transformation rates (7.50% VS 7.69%), and annual transformation rates (2.86% VS 1.93%). The prevalence of ventrolateral tongue leukoplakia is higher than the dorsal tongue leukoplakia (P < 0.001) Conclusions Dorsal tongue leukoplakia is not as frequently encountered clinically as ventrolateral tongue leukoplakia. The response to laser therapy of dorsal tongue and ventrolateral tongue leukoplakia are comparable in postoperative recurrence and postoperative malignant transformation.

Download Full-text

An anatomical perspective on clinicopathological characteristics and treatment outcomes of dorsal and ventrolateral tongue leukoplakia after carbon dioxide laser surgery

BMC Oral Health ◽

10.1186/s12903-021-01403-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shih-Wei Yang ◽

Yun-Shien Lee ◽

Liang-Che Chang ◽

Cheng-Han Yang ◽

Cheng-Ming Luo

Keyword(s):

Carbon Dioxide ◽

Treatment Outcomes ◽

Malignant Transformation ◽

Laser Surgery ◽

Carbon Dioxide Laser ◽

Postoperative Recurrence ◽

Clinicopathological Characteristics ◽

Transformation Rate ◽

Dorsal Tongue ◽

Transformation Rates

Abstract Background The tongue has been identified as a high-risk site for malignant transformation of oral leukoplakia. The purpose of this study was to investigate the clinicopathological characteristics and treatment outcomes of the dorsal and ventrolateral tongue leukoplakia. Methods Demographic data and pathological results of patients who underwent carbon dioxide laser surgery for tongue leukoplakia from 2002 to 2019 were retrospectively reviewed and analyzed statistically. Results Of the 111 patients enrolled, 80 were males and 31 females, with a mean age of 51.86 ± 11.84 years. The follow-up time was 3.74 ± 4.19 years. Fifteen patients had a postoperative recurrence (13.51%). Four (3.6%) patients developed malignant transformation. Annual transformation rate was 1.08%. There were no differences in the time to develop carcinoma (3.19 ± 1.94 vs. 3.51 ± 2.12 years, P = 0.83), overall cumulative malignant transformation rates (7.41% vs. 2.25%, P = 0.12), and annual transformation rates (2.32% vs. 0.64%, P = 0.099). The prevalence of the ventrolateral tongue leukoplakia was higher than that of the dorsal tongue leukoplakia (P < 0.001). The results of multivariate logistic regression analysis showed that the degree of pathology was the only independent prognostic factor related to postoperative malignant transformation (P = 0.045). Conclusions Dorsal tongue leukoplakia is not as frequently encountered clinically as ventrolateral tongue leukoplakia. The response of the dorsal tongue and ventrolateral tongue leukoplakia to laser therapy of are comparable in postoperative recurrence and postoperative malignant transformation. Clinicians should take a more aggressive attitude toward oral tongue leukoplakia with higher grade of dysplasia.

Download Full-text

A Retrospective Cohort Study of Oral Leukoplakia in Female Patients—Analysis of Risk Factors Related to Treatment Outcomes

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168319 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8319

Author(s):

Shih-Wei Yang ◽

Yun-Shien Lee ◽

Pei-Wen Wu ◽

Liang-Che Chang ◽

Cheng-Cheng Hwang

Keyword(s):

Risk Factors ◽

Treatment Outcomes ◽

Malignant Transformation ◽

Carbon Dioxide Laser ◽

Postoperative Recurrence ◽

Clinicopathological Characteristics ◽

Oral Leukoplakia ◽

Female Patients ◽

Significant Difference ◽

Male Patients

Background: The aim of this study was to make a comparison of clinicopathological characteristics of oral leukoplakia between male and female patients following carbon dioxide laser excision for oral leukoplakia and analyze the factors associated with the treatment outcomes in female patients. Methods: Medical records of patients with oral leukoplakia receiving laser surgery from 2002 to 2020 were retrospectively reviewed and analyzed statistically. Results: A total of 485 patients were enrolled, including 412 male (84.95%) and 73 female (15.05%). Regarding the locations, the predilection site of oral leukoplakia in male patients was buccal mucosa (p = 0.0001) and that for women patients was tongue (p = 0.033). The differences of recurrence and malignant transformation between both sexes were not significant (p > 0.05). Among female patients, area of oral leukoplakia was the risk factor related to recurrence (p < 0.05). Clinical morphology and postoperative recurrence were the risk factors related to malignant transformation (p < 0.05). Conclusions: In comparison with male patients, there was no significant difference of the postoperative recurrence and malignant transformation of oral leukoplakia in female patients. Among the female patients, clinicians should pay more attention to large-sized and non-homogeneous leukoplakia, and postoperative recurrent lesions.

Download Full-text

Oral tongue leukoplakia: analysis of clinicopathological characteristics, treatment outcomes, and factors related to recurrence and malignant transformation

Clinical Oral Investigations ◽

10.1007/s00784-020-03735-1 ◽

2021 ◽

Author(s):

Shih-Wei Yang ◽

Yun-Shien Lee ◽

Liang-Che Chang ◽

Cheng-Han Yang ◽

Cheng-Ming Luo ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Treatment Outcomes ◽

Malignant Transformation ◽

Neck Cancer ◽

Clinicopathological Characteristics ◽

Transformation Rate ◽

Oral Tongue ◽

Lesion Area ◽

History Of

Abstract Objectives The tongue is identified as a high-risk site for oral leukoplakia and malignant transformation. The purpose of this study is to investigate the clinicopathological characteristics and treatment outcomes of tongue leukoplakia and assess the factors related to recurrence and malignant transformation. Materials and methods One hundred and forty-four patients who received carbon dioxide laser surgery for tongue leukoplakia from 2002 to 2019 were analyzed statistically. Results The follow-up period was 54.90 ± 54.41 months. Thirty patients showed postoperative recurrence (20.83%), and 12 patients developed malignant transformation (8.33%). The annual transformation rate was 2.28%. Univariate analysis showed that a history of head and neck cancer, size of lesion area, clinical appearance, and pathology were significant factors for both recurrence and malignant transformation. In the multivariate logistic regression, a history of head and neck cancer and size of lesion area were independent prognostic factors for recurrence, and a history of head and neck cancer was the only independent factor for postoperative malignant change. Conclusions Clinicians should adopt more aggressive strategies for tongue leukoplakia patients with a history of head and neck cancer. Clinical relevance These results may help clinicians gain a better understanding of oral tongue leukoplakia.

Download Full-text

Annual malignant transformation rate of oral leukoplakia remains consistent: A long-term follow-up study

Oral Oncology ◽

10.1016/j.oraloncology.2020.105014 ◽

2020 ◽

Vol 110 ◽

pp. 105014

Author(s):

Ilkay Evren ◽

Elisabeth R. Brouns ◽

Leon J. Wils ◽

Jos B. Poell ◽

Carel F.W. Peeters ◽

...

Keyword(s):

Malignant Transformation ◽

Oral Leukoplakia ◽

Transformation Rate ◽

Follow Up Study ◽

Long Term Follow Up

Download Full-text

Trigeminal neuralgia and neuropathy in large sporadic vestibular schwannomas

Journal of Neurosurgery ◽

10.3171/2016.9.jns16515 ◽

2017 ◽

Vol 127 (5) ◽

pp. 992-999 ◽

Cited By ~ 4

Author(s):

Brian A. Neff ◽

Matthew L. Carlson ◽

Megan M. O'Byrne ◽

Jamie J. Van Gompel ◽

Colin L. W. Driscoll ◽

...

Keyword(s):

Trigeminal Neuralgia ◽

Treatment Outcomes ◽

Trigeminal Nerve ◽

Demographic Data ◽

Population Data ◽

Vestibular Schwannomas ◽

Trigeminal Neuropathy ◽

Number Of Patients ◽

Facial Numbness

OBJECTIVEThe aim of this study was to evaluate the incidence, presentation, and treatment outcomes of trigeminal nerve–mediated symptoms secondary to large vestibular schwannomas (VSs) with trigeminal nerve contact. Specifically, the symptomatic results of pain, paresthesias, and numbness after microsurgical resection or stereotactic radiosurgery (SRS) were examined.METHODSThe authors conducted a retrospective review of a database for concomitant diagnosis of trigeminal neuralgia (TN) or trigeminal neuropathy and VS between 1994 and 2014 at a tertiary academic center. All patients with VS with TN or neuropathy were included, with the exception of those patients with neurofibromatosis Type 2 and patients who elected observation. Patient demographic data, symptom evolution, and treatment outcomes were collected. Population data were summarized, and outcome comparisons between microsurgery and SRS were analyzed at last follow-up.RESULTSSixty (2.2%) of 2771 total patients who had large VSs and either TN or neuropathy symptoms met inclusion criteria. The average age of trigeminal symptom onset was 53.6 years (range 24–79 years), the average age at VS diagnosis was 54.4 years (range 25–79 years), and the average follow-up for the microsurgery and SRS groups was 30 and 59 months, respectively (range 3–132 months). Of these patients, 50 (83%) had facial numbness, 16 (27%) had TN pain, and 13 (22%) had paresthesias (i.e., burning or tingling). Subsequently, 50 (83%) patients underwent resection and 10 (17%) patients received SRS.Treatment of VS with SRS did not improve trigeminal symptoms in any patient. This included 2 subjects with unimproved facial numbness and 4 patients with worsened numbness. Similarly, SRS worsened TN pain and paresthesias in 5 patients and failed to improve pain in 2 additional patients. The Barrow Neurological Institute neuralgia and hypesthesia scale scores were significantly worse for patients undergoing SRS compared with microsurgery.Resection alleviated facial numbness in 22 (50%) patients, paresthesias in 5 (42%) patients, and TN in 7 (70%) patients. In several patients, surgery was not successful in relieving facial numbness, which failed to improve in 17 (39%) cases and became worse in 5 (11%) cases. Also, surgery did not change the intensity of facial paresthesias or neuralgia in 6 (50%) and 3 (25%) patients, respectively. Microsurgery exacerbated facial paresthesias in 1 (8%) patient but, notably, did not aggravate TN in any patient.CONCLUSIONSOverall, resection of large VSs provided improved outcomes for patients with concomitant TN, facial paresthesia, and numbness compared with SRS. However, caution should be used when counseling surgical candidates because a number of patients did not experience improvement. This was especially true in patients with preoperative facial numbness and paresthesias, who frequently reported that these symptoms were unchanged following surgery.

Download Full-text

The Characteristics of Patients with Oral Lichen Planus and Malignant Transformation—A Retrospective Study of 271 Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126525 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6525

Author(s):

Vladimíra Radochová ◽

Romana Koberová Ivančaková ◽

Ondřej Heneberk ◽

Radovan Slezák

Keyword(s):

Retrospective Study ◽

Malignant Transformation ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Chronic Inflammatory Disease ◽

University Hospital ◽

Unknown Etiology ◽

Transformation Rate ◽

Oral Lichen

Introduction: Oral lichen planus (OLP) is a chronic inflammatory disease with an unknown etiology rating among oral potentially malignant disorder. The aim of the study was to determine the epidemiological and clinical characteristics of the patients with OLP and rate of malignant transformation. Patients and methods: Data were obtained from the medical records of 271 patients referred to the Oral Medicine Unit at the University Hospital in Hradec Králové diagnosed with oral lichen planus in the period of 2003–2020. The records were retrospectively analyzed. The following clinical data were retrieved from the medical charts: gender, age, systemic diseases, alcohol and tobacco consumption, localization/clinical appearance of lesions, distribution of the lesions, presence of the symptoms, treatment provided and malignant transformation. Results: A total of 271 charts of patients with confirmed diagnosis of OLP were retrospectively analyzed, of whom, 66.4% (180/271) were women and 33.6% (91/271) were men. The mean age of the patients was 56.0 (18.2–85.0) years. The median follow-up of all patients was 15.2 months. Overall, 2 patients (2/271, 0.74%) meeting the above-mentioned criteria for malignant transformation were identified during the follow-up period. Both patients suffered from erosive type OLP and developed squamous cell carcinoma of the tongue. Conclusions: This retrospective study is in concordance with other studies showing the similar profile and clinical features of the patients with OLP. Malignant transformation rate was 0.74%.

Download Full-text

MPC-4 Malignant transformation of diffuse low-grade gliomas: systematic review and meta-analysis

Neuro-Oncology Advances ◽

10.1093/noajnl/vdab159.059 ◽

2021 ◽

Vol 3 (Supplement_6) ◽

pp. vi16-vi16

Author(s):

Satoshi Nakasu ◽

Yoko Nakasu

Keyword(s):

Malignant Transformation ◽

Meta Analysis ◽

Progression Free Survival ◽

Molecular Data ◽

Critical Event ◽

Low Grade ◽

Transformation Rate ◽

Related Factors ◽

Kaplan Meier

Abstract While malignant transformation of diffuse low-grade glioma (LGG) is a critical event affecting the patient survival, the incidence and related factors have been inconsistent in the literature. According to the PRISMA guideline, we systematically reviewed articles from 2009, meta-analyzed the incidence of malignant transformation and clarified factors related to the transformation. Forty-one articles were included in this study (n = 7122). We identified two definitions of malignant transformation: histologically proven (Htrans) and clinically defined (Ctrans). The malignant transformation rate curves in Htrans and Ctrans were almost in parallel when calculated from the results of meta-regression by the mean follow-up time. The true transformation rate was supposed to lie between the two curves, namely about 40% at the 10-year mean follow-up. Risk of malignant transformation was evaluated by the hazard ratio (HR). Pooled HRs were significantly higher in tumors with a larger pre- and postoperative tumor volume, lower degree of resection and notable preoperative contrast enhancement on magnetic resonance imaging than in others. Oligodendroglial histology and IDH mutation (IDHm) with 1p/19q codeletion (Codel) also significantly reduced the HRs. Using Kaplan-Meier curves from 8 studies with molecular data, we extracted data and calculated the 10-year malignant progression free survival (10yMPFS). The 10yMPFS in patients with IDHm without Codel was 30.4% (95% confidence interval (95%CI) [22.2–39.0]) in Htrans and 38.3% (95%CI [32.3–44.3]) in Ctrans, and that with IDHm with Codel was 71.7% (95%CI [61.7–79.5]) in Htrans and 62.5% (95%CI [55.9–68.5]) in Ctrans. The effect of adjuvant radiotherapy or chemotherapy could not be determined.

Download Full-text

Role of Candida infection in the malignant transformation of oral leukoplakia: A systematic review of observational studies

Translational Research in Oral Oncology ◽

10.1177/2057178x19828229 ◽

2019 ◽

Vol 4 ◽

pp. 2057178X1982822 ◽

Cited By ~ 4

Author(s):

Khilan Shukla ◽

Ida Vun ◽

Ivan Lov ◽

George Laparidis ◽

Caitlin McCamley ◽

...

Keyword(s):

Systematic Review ◽

Malignant Transformation ◽

Candida Infection ◽

Oral Leukoplakia ◽

Medical Subject Heading ◽

Exclusion Criteria ◽

Candidal Infection ◽

Transformation Rates

The aim of this systematic review was to investigate the malignant transformation of oral leukoplakia (OL) infected with Candida. Literature search was conducted using Medical Subject Heading terms ‘leukoplakia’, ‘neoplasms’, ‘ Candida’, ‘malignant transformation’ and ‘oral’ and included all results until February 2017. The initial search identified 372 articles, which was consolidated to 16 articles after applying inclusion and exclusion criteria. The occurrence of candidal infection in OL ranged from 6.8% to 100.0%. Only 3 of 16 studies reported malignant transformation rates of leukoplakia with Candida infection. The overall malignant transformation rates reported in these studies were 2.5%, 6.5% and 28.7%. This review supports the contention that candidal infection promotes cellular and dysplastic changes in OL. However, further follow-up studies are recommended to confirm the role of Candida infection in malignant transformation of OL lesions.

Download Full-text