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International Journal of Clinical Oncology

, Volume 16, Issue 1, pp 5–14 | Cite as

Oral premalignant lesions: from a clinical perspective

  • Teruo AmagasaEmail author
  • Masashi Yamashiro
  • Narikazu Uzawa
Review Article

Abstract

In this review article, the clinical and histopathological characteristics of oral premalignant lesions, and primarily oral leukoplakia, are noted and the risk factors for malignant transformation of oral leukoplakia are discussed. Malignant transformation rates of oral leukoplakia range from 0.13 to 17.5%. The risk factors of malignant transformation in the buccal mucosa and labial commissure are male gender with chewing tobacco or smoking in some countries such as India, or older age and/or being a non-smoking female in other countries. Some authors have reported that leukoplakia on the tongue or the floor of the mouth showed a high risk of malignant transformation, although others have found no oral subsites at high risk. In concurrence with some authors, the authors of this review view epithelial dysplasia as an important risk factor in malignant transformation; however, there are conflicting reports in the literature. Many authors believe that nonhomogeneous leukoplakia is a high risk factor without exception, although different terms have been used to describe those conditions. The large size of lesions and widespread leukoplakia are also reported risk factors. According to some studies, surgical treatment decreased the rate of malignant transformation; however, many review articles state that no definitive treatment including surgery can decrease the malignant transformation rate of oral leukoplakia because of the lack of randomized control trials of treatment. Tobacco chewing and smoking may be causative agents for cancerization of oral leukoplakia in some groups, and evidence for a role of human papilloma virus in the malignant transformation of oral leukoplakia is inconsistent. Further research to clarify its role in malignant transformation is warranted.

Keywords

Oral premalignant lesion Potentially malignant disorders Leukoplakia Erythroplakia Malignant transformation Epithelial dysplasia 

Notes

Conflict of interest

No author has any conflict of interest.

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Copyright information

© Japan Society of Clinical Oncology 2011

Authors and Affiliations

  • Teruo Amagasa
    • 1
    Email author
  • Masashi Yamashiro
    • 1
  • Narikazu Uzawa
    • 1
  1. 1.Maxillofacial Surgery, Graduate SchoolTokyo Medical and Dental UniversityTokyoJapan

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