Patient-reported pain after surgical removal of leukoplakia - an observational 1-year follow-up study

• Published in: Acta odontologica Scandinavica Vol. 79; no. 5; pp. 383 - 389
• Main Authors: Korytowska, Magdalena, Schwab, Gabriela, Giglio, Daniel, Hirsch, Jan-Micháel, Holmberg, Erik, Kjeller, Göran, Sand, Lars, Wallström, Mats, Öhman, Jenny, Braz-Silva, Paulo, Hasséus, Bengt
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 2021
• Subjects: Female; Follow-Up Studies; Humans; Leukoplakia; Leukoplakia, Oral - surgery; Mouth Mucosa - surgery; Pain; Patient Reported Outcome Measures; potentially malignant oral disorders; surgical excision; pain; Leukoplakia; surgical excision; potentially malignant oral disorders
• ISSN: 0001-6357; 1502-3850
• DOI: 10.1080/00016357.2020.1869826

Oral leukoplakia (OL) presents as a white lesion of the oral mucosa and is not typically associated with the sensation of pain. OL should be surgically removed when possible because it is considered a potentially malignant oral disorder (PMOD). This study assessed the pain sensations experienced by patients in association with the occurrence and surgical treatment of OL. Inclusion criteria were: a clinical diagnosis of OL; biopsy excision; and observation for at least 12 months in the ORA-LEU-CAN study. At the first visit, all the patients were asked about the occurrence of symptoms within the lesion. Ninety-four subjects were assessed over a period of 1 year. All patients underwent complete removal of OL. The patient cohort was divided into three sub-groups: (i) no pain before excision and at the 1-year follow-up; (ii) pain before excision; and (iii) pain at the 1-year follow-up. Overall, pain was reported by 21.3% of the patients at the study start whereas 13.8% of the patients reported pain 1 year after surgical treatment. Patient-reported pain from the lesion at study inclusion was significantly associated with lesions found on the lateral side of the tongue (p=.002). Pain reported by patients one year after surgery was significantly related to female gender (p=.038) and the presence of epithelial cell dysplasia (p=.022). We conclude that surgical removal of OL results in a low risk of long-term post-surgical pain. However, OL located on the lateral side of the tongue and in OL with dysplasia are more likely to be associated with pain.