Recurrence of Oral Leukoplakia after CO2 Laser Resection: A Prospective Longitudinal Study

Abstract

Aim: The aim of this study is to assess the efficacy of CO₂ laser treatment in oral leukoplakia and to analyse the recurrence rate of oral leukoplakia lesions at 18-month follow-up.

Materials and methods: A prospective clinical study regarding CO₂ laser treatment for oral leukoplakia was conducted, in which 39 patients with a total of 53 oral leukoplakias were included. Follow-up was performed at 18 months post-surgery and the following variables were studied: sex, age, associated risk factors, clinical classification, size, location and presence of epithelial dysplasia, recurrence, and rate of malignant transformation after resection.

Results: In the analysis of the final results 18 months after baseline, a treatment success rate of 43.75% was observed. Oral leukoplakia recurred in 54.17% of cases, and 2.08% of leukoplakias progressed to cancer. Among all the studied variables (age, tobacco use, size, location, clinical type or histology), no significant differences were found with regard to recurrence.

Conclusion: The use of CO₂ laser therapy to treat leukoplakia lesions is sufficient to remove such lesions. However, parameters that can assess recurrence need to be sought.

Keywords: CO2 laser; oral leukoplakia; oral squamous cell carcinoma; recurrence.

Figure 1

(A). Oral leukoplakia Before CO₂. (B) Immediately after treatment.

Figure 2

(A) Lesion before CO₂. (B) Immediately after carbon dioxide surgery.

Figure 3

(A) before removal with CO₂ laser on lingual margin and (B) 3 months after treatment.

Figure 4

Survival curve developed by the Kaplan-Meier method. Patient disease-free survival at 18 months was 23.3 ± 0.06, with an estimated 10.2 ± 0.8 months (95% CI = 8.63–11.8) on average until recurrence of the lesion.