Proliferative verrucous leukoplakia: a follow-up study of 54 cases

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Aug;84(2):154-7. doi: 10.1016/s1079-2104(97)90062-7.


Objectives: Proliferative verrucous leukoplakia is a unique form of oral leukoplakia that has a high risk for becoming dysplastic and transforming into squamous cell carcinoma. The purpose of this review is to update patient profiles, pathogenesis, and survival.

Study design: Fifty-four patients with proliferative verrucous leukoplakia (17 from a previous report) were followed prospectively in our clinic for a mean of 11.6 years after initial biopsy.

Results: In the patient population studied, the mean age was 62 years, and women outnumbered men 4 to 1. Multiple intraoral sites were involved (mean, 2.6 per patient); the most common sites were buccal mucosa in women and tongue in men. In a mean time of 7.7 years, 70.3% of the patients developed a squamous cell carcinoma at a proliferative verrucous leukoplakia site, most frequently the gingiva and tongue. Twenty-one of the patients with proliferative verrucous leukoplakia died of proliferative verrucous leukoplakia-associated carcinoma. Only 31% of the 54 patients used tobacco in any form. Radiation did not appear to enhance surgical control.

Conclusions: Proliferative verrucous leukoplakia is a high risk precancerous lesion with a high mortality rate. Because of both the propensity for progression to dysplasia and malignancy, as well as a high recurrence rate, these patients must be treated aggressively and followed carefully.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Carcinoma, Squamous Cell / etiology*
  • Carcinoma, Squamous Cell / surgery
  • Carcinoma, Verrucous / etiology*
  • Carcinoma, Verrucous / surgery
  • Cell Transformation, Neoplastic
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Leukoplakia, Oral / complications*
  • Leukoplakia, Oral / pathology*
  • Male
  • Middle Aged
  • Mouth Neoplasms / etiology*
  • Mouth Neoplasms / surgery
  • Risk Factors
  • Sex Ratio
  • Smoking / adverse effects
  • Warts / complications
  • Warts / pathology