Skip to main content

Leukoplakia

  • Chapter
  • First Online:
Orofacial Disorders

Abstract

Oral leukoplakia is the most common premalignant lesion or disorder of the oral mucosa. The annual malignant transformation rate amounts approximatey 1%-2%. Of the many predictors of future cancer development, including a vast number of genetic and molecular biomarkers, the presence and degree of epithelial dysplasia is still the most important one. Nevertheless, malignant transformation may also occur in non-dysplastic leukoplakias. Furthermore, dysplastic leukoplakias in non-smokers carry a higher risk of cancer development.Spontaneous regression is rather rare. In small lesions, e.g. less than 2-3 cm, the taking of an excisional biopsy is recommended. In case of larger or multiple lesions surgical removal may be limited to the clinically most suspicious area, if any, and may be combined with CO2 laser evaporation. Because of the lack of prospective randomized trials it is questionable whether removal of leukoplakias does truly eliminate or reduce the risk of future development of oral cancer. At the same time, most patients ask for active treatment, if feasible, instead of just a wait-and-see strategy. All patients with leukoplakias, being actively treated or not, should be followed-up with intervals of three to six months, depending, a.o. of the histopathological findings.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Parashar P. Proliferative verrucous leukoplakia: an elusive disorder. J Evid Based Dent Pract. 2014;(Suppl):147ā€“53.

    Google ScholarĀ 

  2. Petti S. Pooled estimate of world leukoplakia prevalence: a systematic review. Oral Oncol. 2003;39(8):770ā€“80.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  3. Warnakulasuriya S, Ariyawardana A. Malignant transformation of oral leukoplakia: a systemic review of observational studies. J Oral Pathol Med. 2015; doi: 10.1111/jop.12339. Epub ahead of print.

  4. Ho MW, Risk JM, Woolgar JA, Field EA, Field JK, Steele JC, et al. The clinical determinants of malignant transformation in oral dysplasia. Oral Oncol. 2012;48(10):969ā€“76.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  5. William Jr WN. Oral premalignant lesions: any progress with systemic therapies? Curr Opin Oncol. 2012;24(3):205ā€“2010.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  6. Graveland AP, Bremmer JF, de Maaker M, Brink A, Cobussen P, Zwart M, et al. Molecular screening of oral precancer. Oral Oncol. 2013;49(12):1129ā€“35.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  7. Chainani-Wu N, Madden E, Cox D, Sroussi H, Epstein J, Silverman Jr S. Toluidine blue aids in detection of dysplasia and carcinoma in suspicious oral lesions. Oral Dis. 2015;21(7):879ā€“85.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  8. Speight PM, Abram TJ, Floriano PN, James BS, Vick J, Thornhill MH, et al. Interobserver agreement in dysplasia grading: toward an enhanced gold standard for clinical pathology trials. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120(4):474ā€“82.

    ArticleĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  9. Holmstrup P. Can we prevent malignancy by treating premalignant lesions? Editorial Oral Oncol. 2009;45(7):549ā€“50.

    Google ScholarĀ 

  10. Anderson A, Ishak N. Marked variation in malignant transformation rates of oral leukoplakia. Evid Based Dent. 2015;16(4):102ā€“3.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  11. Balasundaram I, Payne KF, Al-Hadad I, Alibhai M, Thomas S, Bhandari R. Is there any benefit in surgery for potentially malignant disorders of the oral cavity? J Oral Pathol Med. 2014;43(4):239ā€“44.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  12. Kuribayashi Y, Tsushima F, Morita K, Matsumoto K, Sakurai J, Uesugi A, et al. Long-term outcome of non-surgical treatment in patients with oral leukoplakia. Oral Oncol. 2015;51(11):1020ā€“5.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  13. Kuribayashi Y, Tsushima F, Sato M, Morita K, Omura K. Recurrence patterns of oral leukoplakia after curative surgical resection: important factors that predict the risk of recurrence and malignancy. J Oral Pathol Med. 2012;41(9):682ā€“8.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  14. Arnaoutakis D, Bishop J, Westra W, Califano JA. Recurrence patterns and management of oral cavity premalignant lesions. Oral Oncol. 2013;49(8):814ā€“7.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

  15. Vladimirov BS, SchiĆødt M. The effect of quitting smoking on the risk of unfavorable events after surgical treatment of oral potentially malignant lesions. Int J Oral Maxillofac Surg. 2009;38(11):1188ā€“93.

    ArticleĀ  PubMedĀ  Google ScholarĀ 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to IsaƤc van der Waal DDS, PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

Ā© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

van der Waal, I. (2017). Leukoplakia. In: Ferreira, J., Fricton, J., Rhodus, N. (eds) Orofacial Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-51508-3_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-51508-3_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-51507-6

  • Online ISBN: 978-3-319-51508-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics