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Meta-Analysis
. 2025 Jan;31(1):89-98.
doi: 10.1111/odi.15098. Epub 2024 Aug 18.

Surgical protocols for oral leukoplakia and precancerous lesions across three different anatomic sites

Caique Mariano Pedroso  1 , Erison Santana do Santos  1 , Fábio Abreu Alves  2   3 , Manoela Domingues Martins  4 , Luiz Paulo Kowalski  5   6 , Marcio Ajudarte Lopes  1 , Saman Warnakulasuriya  7   8 , Alessandro Villa  9   10 , Alan Roger Santos-Silva  1
Affiliations
Meta-Analysis

Surgical protocols for oral leukoplakia and precancerous lesions across three different anatomic sites

Caique Mariano Pedroso et al. Oral Dis. 2025 Jan.

Abstract

Objective: This systematic review and meta-analysis aimed to compare the risk of recurrence and cancer progression after surgical treatment for oral potentially malignant disorders (OPMD) and precancerous lesions in different anatomical sites.

Materials and methods: A comprehensive search was conducted in nine databases and grey literature. We included randomized controlled trials assessing surgical treatment efficacy for OPMD and precancerous lesions of cervical, vaginal, anal, and penile sites. Excision or ablation surgical treatments were considered.

Results: Overall, 12 studies met the eligibility criteria for oral leukoplakia (OL), proliferative verrucous leukoplakia, cervical intraepithelial neoplasia (CIN), vaginal intraepithelial neoplasia, and anal intraepithelial neoplasia (AIN). In qualitative analysis of surgical protocols, the lack of margin description impacts the clinical outcomes of OL and AIN, and the ablative protocols were heterogeneous in both OPMD and precancerous lesions. No significant difference in OL (risk ratio 0.82 [95% CI: 0.59-1.15]) and CIN (risk ratio 0.31 [95% CI: 0.09-1.09]) for recurrence was observed when cold-knife was compared with ablative protocols. OL exhibited higher recurrence and cancer progression rates compared to CIN and AIN.

Conclusion: There is no difference in recurrence risk post-surgical treatment for OL and CIN. Surgical protocols for oral leukoplakia and CIN/AIN lack standardized approaches.

Keywords: anal intraepithelial neoplasia; cervical intraepithelial neoplasia; clinical outcomes; oral leukoplakia; precancer lesions; recurrence; surgical protocols.

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References

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