Risk of Malignant Transformation in 3173 Subjects with Histopathologically Confirmed Oral Lichen Planus: A 33-Year Cohort Study in Northern Italy

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2021 Nov 27

PMID 34830892

Citations 15

Authors

Paolo G Arduino

Alessandro Magliano

Alessio Gambino

Alessandra Macciotta

Mario Carbone

Davide Conrotto

Dora Karimi

Marco Carrozzo

Roberto Broccoletti

Affiliations

Soon will be listed here.

Abstract

Background: Oral lichen planus (OLP) is considered an oral potentially malignant disorder. The aim of our study was to estimate the risk for oral cancer in patients diagnosed with OLP.

Methods: A population-based cohort study between January 1988 and December 2020 at one hospital in Northern Italy was performed. The primary endpoint of the study was that of the histopathological diagnosis of oral cancer during the follow-up period.

Results: The study population comprised 3173 patients. During the follow-up period, 32 men and 50 women developed an oral squamous cell carcinoma (2.58%), with a mean time of 103.61 months after the initial diagnosis of OLP, and 21 patients died because of oral cancer. Almost half of the deceased patients had the last follow-up visit before cancer diagnosis in a period of more than 12 months. Older age, having a red form of OLP and fewer sites of involvement, increased the risk of having cancer, while age and no treatment increased the risk of death.

Conclusion: This is the largest group of OLP patients with such a long follow up ever reported. Due to the increased risk of having a malignant transformation, especially in elderly subjects, OLP patients should be regularly followed up, particularly in the Northern Italian population.

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References

Idrees M, Kujan O, Shearston K, Farah C . Oral lichen planus has a very low malignant transformation rate: A systematic review and meta-analysis using strict diagnostic and inclusion criteria. J Oral Pathol Med. 2020; 50(3):287-298. DOI: 10.1111/jop.12996. View

Tsushima F, Sakurai J, Uesugi A, Oikawa Y, Ohsako T, Mochizuki Y . Malignant transformation of oral lichen planus: a retrospective study of 565 Japanese patients. BMC Oral Health. 2021; 21(1):298. PMC: 8194014. DOI: 10.1186/s12903-021-01652-7. View

Scully C, Beyli M, Ferreiro M, Ficarra G, Gill Y, Griffiths M . Update on oral lichen planus: etiopathogenesis and management. Crit Rev Oral Biol Med. 1998; 9(1):86-122. DOI: 10.1177/10454411980090010501. View

Gonzalez-Moles M, Warnakulasuriya S, Gonzalez-Ruiz I, Ayen A, Gonzalez-Ruiz L, Ruiz-Avila I . Dysplasia in oral lichen planus: relevance, controversies and challenges. A position paper. Med Oral Patol Oral Cir Bucal. 2021; 26(4):e541-e548. PMC: 8254877. DOI: 10.4317/medoral.24610. View

Ramos-Garcia P, Gonzalez-Moles M, Warnakulasuriya S . Oral cancer development in lichen planus and related conditions-3.0 evidence level: A systematic review of systematic reviews. Oral Dis. 2021; 27(8):1919-1935. DOI: 10.1111/odi.13812. View

Rosa E, Hurtado-Puerto A, Falcao D, Brietzke A, De Almeida Prado Franceschi L, Cavalcanti Neto F . Oral lichen planus and malignant transformation: The role of p16, Ki-67, Bub-3 and SOX4 in assessing precancerous potential. Exp Ther Med. 2018; 15(5):4157-4166. PMC: 5920964. DOI: 10.3892/etm.2018.5971. View

Carbone M, Arduino P, Carrozzo M, Gandolfo S, Argiolas M, Bertolusso G . Course of oral lichen planus: a retrospective study of 808 northern Italian patients. Oral Dis. 2009; 15(3):235-43. DOI: 10.1111/j.1601-0825.2009.01516.x. View

Villa A, Menon R, Kerr A, de Abreu Alves F, Guollo A, Ojeda D . Proliferative leukoplakia: Proposed new clinical diagnostic criteria. Oral Dis. 2018; 24(5):749-760. DOI: 10.1111/odi.12830. View

van der Meij E, van der Waal I . Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med. 2003; 32(9):507-12. DOI: 10.1034/j.1600-0714.2003.00125.x. View

10.

Radochova V, Koberova Ivancakova R, Heneberk O, Slezak R . The Characteristics of Patients with Oral Lichen Planus and Malignant Transformation-A Retrospective Study of 271 Patients. Int J Environ Res Public Health. 2021; 18(12). PMC: 8296493. DOI: 10.3390/ijerph18126525. View

11.

Lodi G, Scully C, Carrozzo M, Griffiths M, Sugerman P, Thongprasom K . Current controversies in oral lichen planus: report of an international consensus meeting. Part 1. Viral infections and etiopathogenesis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100(1):40-51. DOI: 10.1016/j.tripleo.2004.06.077. View

12.

Gonzalez-Moles M, Warnakulasuriya S, Gonzalez-Ruiz I, Gonzalez-Ruiz L, Ayen A, Lenouvel D . Clinicopathological and prognostic characteristics of oral squamous cell carcinomas arising in patients with oral lichen planus: A systematic review and a comprehensive meta-analysis. Oral Oncol. 2020; 106:104688. DOI: 10.1016/j.oraloncology.2020.104688. View

13.

Mazzaro C, Dal Maso L, Mauro E, Visentini M, Tonizzo M, Gattei V . Hepatitis C virus- related cryoglobulinemic vasculitis: A review of the role of the new direct antiviral agents (DAAs) therapy. Autoimmun Rev. 2020; 19(8):102589. DOI: 10.1016/j.autrev.2020.102589. View

14.

Gonzalez-Moles M, Ruiz-Avila I, Gonzalez-Ruiz L, Ayen A, Gil-Montoya J, Ramos-Garcia P . Malignant transformation risk of oral lichen planus: A systematic review and comprehensive meta-analysis. Oral Oncol. 2019; 96:121-130. DOI: 10.1016/j.oraloncology.2019.07.012. View

15.

Carrard V, Brouns E, van der Waal I . Proliferative verrucous leukoplakia; a critical appraisal of the diagnostic criteria. Med Oral Patol Oral Cir Bucal. 2013; 18(3):e411-3. PMC: 3668865. DOI: 10.4317/medoral.18912. View

16.

Gilligan G, Garola F, Piemonte E, Leonardi N, Panico R, Warnakulasuriya S . Lichenoid proliferative leukoplakia, lichenoid lesions with evolution to proliferative leukoplakia or a continuum of the same precancerous condition? A revised hypothesis. J Oral Pathol Med. 2020; 50(2):129-135. DOI: 10.1111/jop.13133. View

17.

Best D, Herzog C, Powell C, Braun T, Ward B, Moe J . Oral Lichen Planus-Associated Oral Cavity Squamous Cell Carcinoma Is Associated With Improved Survival and Increased Risk of Recurrence. J Oral Maxillofac Surg. 2020; 78(7):1193-1202. DOI: 10.1016/j.joms.2020.01.032. View

18.

Zotti F, Nocini R, Capocasale G, Bertossi D, Fior A, Peretti M . Oral Lichen Planus: risk factors of malignant transformation and follow up. Ten years retrospective study. J Clin Exp Dent. 2021; 13(7):e630-e636. PMC: 8291160. DOI: 10.4317/jced.57688. View

19.

Warnakulasuriya S, Kujan O, Aguirre-Urizar J, Bagan J, Gonzalez-Moles M, Kerr A . Oral potentially malignant disorders: A consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. Oral Dis. 2020; 27(8):1862-1880. DOI: 10.1111/odi.13704. View

20.

Amin N, Yussif N, Ahmed E . The effect of smoking on clinical presentation and expression of TLR-2 and CD34 in Oral lichen Planus patients: clinical and immunohistochemical study. BMC Oral Health. 2020; 20(1):129. PMC: 7191681. DOI: 10.1186/s12903-020-01118-2. View