Malignant transformation of oral leukoplakia: Systematic review and meta-analysis of the last 5 years

Oral Dis. 2021 Nov;27(8):1881-1895. doi: 10.1111/odi.13810. Epub 2021 Apr 1.

Abstract

Objective: Oral leukoplakia (OL) is the most frequently encountered oral potentially malignant disorder. The aims of this systematic review are to estimate the overall malignant transformation of OL and to assess the risk factors associated with malignant transformation of OL published in the last 5 years (2015-2020).

Materials and methods: We performed a bibliographic search in PubMed, Scopus, Web of Science, Embase, and Cochrane databases with keywords "oral leukoplakia", "oral cancer", "oral carcinoma" and "oral squamous cell carcinoma". Meta-analysis was conducted using a random-effects model.

Results: Twenty-four studies were selected, that reported a total of 16,604 patients. Malignant transformation proportion varied between 1.1% and 40.8%. Female gender, non-homogeneous clinical type, and presence of epithelial dysplasia were significantly related to MT. Other risk factors previously suggested did not show significant results.

Conclusions: The pooled proportion of malignant transformation MT was 9.8% (95% CI: 7.9-11.7). It is necessary to continue to conduct well-designed prospective clinicopathological studies on OL, using a uniform definition for OL to reduce the risk of bias for evaluating various factors associated with the MT.

Keywords: malignant transformation; meta-analysis; oral leukoplakia; risk; systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Carcinoma, Squamous Cell*
  • Cell Transformation, Neoplastic
  • Female
  • Humans
  • Leukoplakia, Oral
  • Mouth Neoplasms*
  • Prospective Studies