Frontiers in Oncology (Apr 2022)

Clinical and Histological Prognostic Factors of Recurrence and Malignant Transformation in a Large Series of Oral Potentially Malignant Disorders

  • Luigi Lorini,
  • Michele Tomasoni,
  • Cristina Gurizzan,
  • Chiara Magri,
  • Mattia Facchetti,
  • Simonetta Battocchio,
  • Chiara Romani,
  • Marco Ravanelli,
  • Arianna Oberti,
  • Anna Bozzola,
  • Elena Bardellini,
  • Alberto Paderno,
  • Davide Mattavelli,
  • Davide Lombardi,
  • Alberto Grammatica,
  • Alberto Deganello,
  • Fabio Facchetti,
  • Stefano Calza,
  • Stefano Calza,
  • Alessandra Majorana,
  • Cesare Piazza,
  • Paolo Bossi

DOI
https://doi.org/10.3389/fonc.2022.886404
Journal volume & issue
Vol. 12

Abstract

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BackgroundOral potentially malignant disorders (OPMDs) represent a heterogeneous set of different histological lesions, characterized by the capacity to transform in oral squamous cell carcinoma (OSCC). Despite optimal surgical treatment, approximately 20%–30% of OPMDs may evolve into OSCC. No clear clinical/histological factors are able to identify OPMDs at higher risk of malignant transformation.Materials and MethodsWe considered surgically treated patients with a diagnosis of OPMDs, enrolled from 1996 to 2019 at ASST Spedali Civili of Brescia without a diagnosis of OSCC within the previous 2 years. Clinical and histological characteristics were recorded. Outcomes of interest were recurrence-free survival (RFS), defined as the time from surgery for primary OPMD to any relapse of OPMD or malignant transformation, whichever occurred first, and carcinoma-free survival (CFS), defined as the time from surgery for OPMD to malignant transformation.ResultsWe retrospectively reviewed 106 OPMDs cases. Median age at first diagnosis was 64 years old (IQR = 18.75); female patients comprise 51.9% of the cases. During a median follow-up of 30.5 months (IQR = 44), in 23.5% of patients, malignant transformation occurred. RFS at 1, 5, and 10 years was 92.4%, 60.9%, and 43.2%, respectively. Female sex and history of previous OSCC were independent risk factors for RFS. CFS at 1, 5, and 10 years of follow-up was 97.1%, 75.9%, and 64.4%, respectively. Previous OSCC was an independent risk factor for CFS.ConclusionsIn this large series of OPMDs, only previous diagnosis of OSCC was a prognostic factor for further OSCC occurrence. Given the lack of additional clinical/pathological prognostic factors, we advocate further studies into molecular characterization of OPMDs to better stratify the risk of malignant transformation.

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