Oral lichen planus and malignant transformation: a longitudinal cohort study

• Published in: Oral surgery, oral medicine, oral pathology, oral radiology and endodontics Vol. 112; no. 3; pp. 328 - 334
• Main Authors: Bombeccari, Gian Paolo, DDS, Guzzi, Gianpaolo, DDS, Tettamanti, Mauro, PhD, Giannì, Aldo Bruno, MD, Baj, Alessandro, MD, Pallotti, Francesco, MD, Spadari, Francesco, MD, DDS
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.09.2011; Elsevier
• Subjects: Aged; Biological and medical sciences; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Cell Transformation, Neoplastic - pathology; Cohort Studies; Dentistry; Dermatology; Disease-Free Survival; Female; Humans; Italy - epidemiology; Lichen Planus, Oral - mortality; Lichen Planus, Oral - pathology; Longitudinal Studies; Male; Medical sciences; Middle Aged; Mouth Neoplasms - mortality; Mouth Neoplasms - pathology; Neoplasm Recurrence, Local; Otorhinolaryngology. Stomatology; Precancerous Conditions - pathology; Prospective Studies; Psoriasis. Parapsoriasis. Lichen; Surgery; Italy; Skin disease; Lichen planus; Cohort study; Malignant transformation; Oral administration
• ISSN: 1079-2104; 1528-395X
• DOI: 10.1016/j.tripleo.2011.04.009

Objective Oral lichen planus (OLP) is associated with risk for developing oral squamous cell carcinoma (OSCC). We performed a 7-year prospective study to assess the incidence of malignant transformation of OLP among adults. Study design Three hundred twenty-seven OLP patients, 229 women (70.0%) and 98 men (30.0%), were observed during the follow-up period. Results During a mean follow-up of 81.7 months, 8 of 327 patients developed an OSCC in OLP areas (0.36%/y), yielding the high overall standardized incidence ratio of 17.7 (95% confidence interval [CI] 8.8-35.3). The standardized incidence ratio for OSCC was significantly higher in women [27.0 (95% CI 11.2-64.8)] than in men [11.2 (95% CI 3.6-34.9)]. Six OSCCs were well differentiated (75%) and 2 moderately differentiated (25%). Three subjects (37.5%) developed recurrences within 2 years (mean 16.1 ± 3.5 months). Disease-free survival rate after 69.8 months was 97.3%. Conclusions OLP was associated with a significant increase in the risk for OSCC. Close surveillance may help to reduce the morbidity of OSCC arising from OLP at 24 months.