Long-term outcome of non-surgical treatment in patients with oral leukoplakia

• This study aimed to use a long-term wait-and-see approach with oral leukoplakia.
• Either non-homogenous or lesions located on the tongue were likely to turn cancerous.
• Removal of irritation for a long time may lead to contribute to the treatment.
• The new treatments may differentiate between surgical and observation cases.

SummaryThe standard treatments for oral leukoplakia range from careful observation to complete resection. No surgical intervention is chosen for several supposable reasons. Surgical treatment and no surgical treatment for oral leukoplakia have no defined basis for comparisons, and few studies have reported on the long-term outcomes of oral leukoplakia without surgery.ObjectivesThis study aimed to identify the important factors using a long-term wait-and-see policy in patients with oral leukoplakia.Materials and methodsIn total, 237 lesions from 218 patients selected for non-surgical therapy between 2001 and 2010 were analyzed. On the basis of long-term follow-up data, lesions were classified as unchanged, reduced, disappeared, expanded, and malignantly transformed.ResultsIn total, 135 (57.0%) lesions remained unchanged, 30 (12.7%) lesions were characterized by a reduction in size or clinical severity, and 44 (18.6%) lesions had disappeared. Another 17 (7.2%) lesions resulted in spread or clinical deterioration, and 11 (4.6%) lesions developed oral squamous cell carcinoma.ConclusionsWe demonstrated a cumulative malignant transformation rate of 11.6% in 10 years without resection. The lesions that were nonhomogeneous, and higher degree of epithelial dysplasia, located on the tongue were likely to progress into cancer. In addition, 32.5% of lesions without surgical treatment were reduced or disappeared. There is a possibility that removal of considerable irritation for a long time contributes to the treatment of this disease. The development of appropriate treatments for oral leukoplakia is required, which will enable successful differentiation between surgical and observation cases.