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. 2014 Aug 5:14:99.
doi: 10.1186/1472-6831-14-99.

Malignant transformation in 5071 southern Taiwanese patients with potentially malignant oral mucosal disorders

Yen-Yun Wang, Yen-Hsuan Tail, Wen-Chen Wang, Ching-Yi Chen, Yu-Hsun Kao, Yuk-Kwan Chen  1 , Chung-Ho Chen
Affiliations

Malignant transformation in 5071 southern Taiwanese patients with potentially malignant oral mucosal disorders

Yen-Yun Wang et al. BMC Oral Health. .

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.

Conclusion: Patients with OPMDs require long-term follow up.

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Figures

Figure 1
Figure 1
The annual malignant transformation rate of the current study.
Figure 2
Figure 2
The annual malignant transformation rate of oral potentially malignant disorders (p < 0.0001; log-rank test).
Figure 3
Figure 3
Comparison of the annual malignant transformation rate of the current study with the previous study (1991–2001). (Red line: The current study; blue line: Previous study) (p = 0.0104; log-rank test).
See this image and copyright information in PMC

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