This study was presented at the American Head & Neck Society Annual Meeting, San Francisco, USA, July 23, 2008, and British Association of Head and Neck Oncologists Annual Meeting, London, United Kingdom, April 25, 2008 (poster).
Treatment and follow-up of oral dysplasia — A systematic review and meta-analysis†
Article first published online: 19 MAY 2009
Copyright © 2009 Wiley Periodicals, Inc.
Head & Neck
Volume 31, Issue 12, pages 1600–1609, December 2009
How to Cite
Mehanna, H. M., Rattay, T., Smith, J. and McConkey, C. C. (2009), Treatment and follow-up of oral dysplasia — A systematic review and meta-analysis. Head Neck, 31: 1600–1609. doi: 10.1002/hed.21131
- Issue published online: 9 NOV 2009
- Article first published online: 19 MAY 2009
- Manuscript Accepted: 18 FEB 2009
- Manuscript Revised: 1 FEB 2009
- Manuscript Received: 7 SEP 2008
- oral lesion;
The aim of this study was to inform an evidence-based management policy for oral dysplastic lesions.
Systematic review was performed with meta-analysis. Studies reporting follow-up of patients with histologically confirmed oral dysplasia were included. Outcome measures included malignant transformation rate (MTR) and time to malignant transformation (TMT). Subgroup analysis was performed by histologic grade, clinical risk factors, and treatment modality. Heterogeneity was assessed.
Fourteen nonrandomized studies, reporting on 992 patients, were included. There was considerable heterogeneity between studies: mean overall MTR = 12.1% (confidence interval: 8.1%, 17.9%) and mean TMT = 4.3 years. Histologic grade significantly affected mean MTR (p < .008). Lesions that were not excised demonstrated considerably higher MTR than those that were excised (p = .003).
Oral dysplasia showed a significant rate of transformation to cancer, which was related to grade and was decreased significantly but not eliminated by excision. This suggested the need for excision and continued surveillance. © 2009 Wiley Periodicals, Inc. Head Neck, 2009