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Article: Interventional laser surgery for oral potentially malignant disorders: a longitudinal patient cohort study

TitleInterventional laser surgery for oral potentially malignant disorders: a longitudinal patient cohort study
Authors
Keywordsearly diagnosis of cancer
oral potentially malignant disorders
interventional laser surgery
Issue Date2017
PublisherChurchill Livingstone. The Journal's web site is located at http://www.elsevier.com/locate/ijom
Citation
International Journal of Oral and Maxillofacial Surgery, 2017, v. 46 n. 3, p. 337-342 How to Cite?
Abstract© 2016 International Association of Oral and Maxillofacial Surgeons Oral squamous cell carcinoma (OSCC) is a lethal disease, with rising incidence. There were 6767 new OSCC cases and 2056 deaths in the UK in 2011. Cancers are preceded by oral potentially malignant disorders (PMDs), recognizable mucosal diseases harbouring increased SCC risk, offering clinicians a â therapeutic windowâ to intervene. Contemporary practice remains unable to predict lesion behaviour or quantify malignant transformation risk. No clear management guidelines exist and it is unclear from the literature whether early diagnosis and intervention prevents cancer. Between 1996 and 2014, 773 laser treatments were performed on 590 PMD patients in Newcastle maxillofacial surgery departments. The efficacy of the intervention was examined by review of the clinicopathological details and clinical outcomes of the patients (mean follow-up 7.3 years). Histopathology required up-grading in 36.1% on examining excision specimens. Seventy-five percent of patients were disease-free, mostly younger patients with low-grade dysplasia; 9% exhibited persistent disease and were generally older with proliferative verrucous leukoplakia. Disease-free status was less likely for erythroleukoplakia (P = 0.022), â high-gradeâ dysplasia (P  <  0.0001), and with lichenoid inflammation (P = 0.028). Unexpected OSCC was identified in 12.0%, whilst 4.8% transformed to malignancy. Interventional laser surgery facilitates definitive diagnosis and treatment, allows early diagnosis of OSCC, identifies progressive disease, and defines outcome categories. Evidence is lacking that intervention halts carcinogenesis. Multicentre, prospective, randomized controlled trials are needed to confirm the efficacy of surgery.
Persistent Identifierhttp://hdl.handle.net/10722/249136
ISSN
2023 Impact Factor: 2.2
2023 SCImago Journal Rankings: 0.875
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorThomson, PJ-
dc.contributor.authorGoodson, ML-
dc.contributor.authorCocks, K-
dc.contributor.authorTurner, JE-
dc.date.accessioned2017-10-27T05:59:12Z-
dc.date.available2017-10-27T05:59:12Z-
dc.date.issued2017-
dc.identifier.citationInternational Journal of Oral and Maxillofacial Surgery, 2017, v. 46 n. 3, p. 337-342-
dc.identifier.issn0901-5027-
dc.identifier.urihttp://hdl.handle.net/10722/249136-
dc.description.abstract© 2016 International Association of Oral and Maxillofacial Surgeons Oral squamous cell carcinoma (OSCC) is a lethal disease, with rising incidence. There were 6767 new OSCC cases and 2056 deaths in the UK in 2011. Cancers are preceded by oral potentially malignant disorders (PMDs), recognizable mucosal diseases harbouring increased SCC risk, offering clinicians a â therapeutic windowâ to intervene. Contemporary practice remains unable to predict lesion behaviour or quantify malignant transformation risk. No clear management guidelines exist and it is unclear from the literature whether early diagnosis and intervention prevents cancer. Between 1996 and 2014, 773 laser treatments were performed on 590 PMD patients in Newcastle maxillofacial surgery departments. The efficacy of the intervention was examined by review of the clinicopathological details and clinical outcomes of the patients (mean follow-up 7.3 years). Histopathology required up-grading in 36.1% on examining excision specimens. Seventy-five percent of patients were disease-free, mostly younger patients with low-grade dysplasia; 9% exhibited persistent disease and were generally older with proliferative verrucous leukoplakia. Disease-free status was less likely for erythroleukoplakia (P = 0.022), â high-gradeâ dysplasia (P  <  0.0001), and with lichenoid inflammation (P = 0.028). Unexpected OSCC was identified in 12.0%, whilst 4.8% transformed to malignancy. Interventional laser surgery facilitates definitive diagnosis and treatment, allows early diagnosis of OSCC, identifies progressive disease, and defines outcome categories. Evidence is lacking that intervention halts carcinogenesis. Multicentre, prospective, randomized controlled trials are needed to confirm the efficacy of surgery.-
dc.languageeng-
dc.publisherChurchill Livingstone. The Journal's web site is located at http://www.elsevier.com/locate/ijom-
dc.relation.ispartofInternational Journal of Oral and Maxillofacial Surgery-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectearly diagnosis of cancer-
dc.subjectoral potentially malignant disorders-
dc.subjectinterventional laser surgery-
dc.titleInterventional laser surgery for oral potentially malignant disorders: a longitudinal patient cohort study-
dc.typeArticle-
dc.identifier.emailThomson, PJ: thomsonp@hku.hk-
dc.identifier.authorityThomson, PJ=rp02327-
dc.description.naturepostprint-
dc.identifier.doi10.1016/j.ijom.2016.11.001-
dc.identifier.scopuseid_2-s2.0-85006823210-
dc.identifier.hkuros283310-
dc.identifier.volume46-
dc.identifier.issue3-
dc.identifier.spage337-
dc.identifier.epage342-
dc.identifier.eissn1399-0020-
dc.identifier.isiWOS:000394071500011-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl0901-5027-

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