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Clinical predictors of malignant transformation and recurrence in oral potentially malignant disorders: A systematic review and meta-analysis.

Mariana de Pauli Paglioni,S. Khurram,Blanca Iciar Indave Ruiz,B. Lauby-Secretan,A. Normando,A. Ribeiro,T. Brandão,N. Palmier,M. Lopes,E. Guerra,M. Meleti,C. Migliorati,A. Carvalho,L. L. de Matos,L. Kowalski,A. Santos-Silva

Published 2022 in Oral surgery, oral medicine, oral pathology and oral radiology

ABSTRACT

OBJECTIVE We performed a systematic review dedicated to pooling evidence for the associations of clinical features with malignant transformation (MT) and recurrence of 3 oral potentially malignant disorders (OPMDs) (actinic cheilitis [AC], oral leukoplakia [OL], and proliferative verrucous leukoplakia [PVL]). STUDY DESIGN We selected studies that included clinical features and risk factors (age, sex, site, size, appearance, alcohol intake, tobacco use, and sun exposure) of OL, PVL, and AC associated with recurrence and/or MT. RESULTS Based on the meta-analysis results, non-homogeneous OL appears to have a 4.53 times higher chance of recurrence after treatment. We also found 6.52 higher chances of MT of non-homogeneous OL. Another clinical feature related to higher MT chances is the location (floor of the mouth and tongue has 4.48 higher chances) and the size (OL with >200 mm2 in size has 4.10 higher chances of MT). Regarding habits, nonsmoking patients with OL have a 3.20 higher chance of MT. The only clinical feature related to higher chances of MT in patients with PVL was sex (females have a 2.50 higher chance of MT). CONCLUSIONS Our study showed that some clinical features may indicate greater chances of recurrence after treatment and MT of OPMD.

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