Oral Proliferative Verrucous Leukoplakia: Progression to Malignancy and Clinical Implications. Systematic Review and Meta-Analysis
Abstract
:Simple Summary
Abstract
1. Introduction
- (1)
- White/keratotic lesions that can be smooth, fissured, verrucous, or erythematous, with or without the presence of ulcerated areas.
- (2)
- Non-contiguous multifocal lesions or single lesions larger than 4 cm in a single site or single lesions larger than 3 cm with the involvement of contiguous sites.
- (3)
- Lesions that progress/expand and/or develop multifocality over time.
- (4)
- Histopathology, which, in absence of dysplasia or carcinoma, still shows hyperkeratosis, parakeratosis, atrophy, or acanthosis with minimal or absent cytological atypia, with or without the presence of a lymphocytic band, or verrucous hyperplasia.
2. Materials and Methods
- −
- PubMed.
- −
- Scopus.
- −
- Web of Science (WOS Core Collection).
- −
- Cochrane Library.
- −
- Studies involving at least 10 PVL patients.
- −
- Diagnosis of PVL carried out on the basis of the criteria defined by Hansen et al. [2], or subsequent modifications.
- −
- Studies reporting the number of patients who, over time, developed oral cancer as a consequence of PVL neoplastic transformation.
- −
- Articles in which the mean follow-up of PVL patients was explicitly reported.
- First author;
- Year of publication;
- Country in which the study was conducted;
- Enrolment period of patients;
- Type of study with any statistical analysis applied;
- Number of patients with PVL diagnosis;
- Gender;
- Mean age;
- Mean duration of follow-up;
- Current or past use of tobacco or alcohol;
- Number of patients who underwent neoplastic transformation of the lesion, including the number of men and women;
- Subjects who developed verrucous carcinoma or conventional oral squamous cell carcinoma (included gender);
- Number of patients who developed multiple carcinomas in different intraoral sites;
- Mean time from diagnosis of PVL to neoplastic transformation;
- Mean number of biopsies per patient;
- Mean time between first and eventual second primary oral carcinoma;
- Number of patients who died from causes related to oral carcinoma;
- The site most frequently involved by the onset of PVL or by malignant transformation.
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Authors | Year of Publication | Number of PVL Patients | Patients Enrolment Period | Type of Study |
---|---|---|---|---|
Hansen et al. [2] | 1985 | 30 | 1961–1983 | Retrospective case series |
Zakrzewska et al. [7] | 1996 | 10 | - | Case series |
Silverman e Gorsky [8] | 1997 | 54 | - | Case series |
Schoelch et al. [9] | 1999 | 12 | - | Case series |
Fettig et al. [10] | 2000 | 10 | 1995–1999 | Case series |
Bagan et al. [11] | 2003 | 30 | - | Case control |
Bagan et al. [12] | 2004 | 19 | - | Case series |
Gandolfo et al. [13] | 2009 | 47 | 1981–2006 | Retrospective case control |
Poveda-Roda et al. [14] | 2010 | 17 | - | Preliminary study |
Gouvea et al. [15] | 2013 | 21 | - | Retrospective case control |
Garcìa-Chìas et al. [16] | 2014 | 40 | 1984–2011 | Retrospective case series |
Flores et al. [17] | 2016 | 15 | - | Case control |
Garcìa-Pola et al. [18] | 2016 | 14 | 1984–2015 | Observational descriptive study |
Borgna et al. [19] | 2016 | 48 | 1990–2015 | Retrospective case series |
Thomson et al. [20] | 2018 | 80 | 1996–2014 | Retrospective cohort |
Upadhyaya et al. [21] | 2018 | 20 | 1994–2016 | Retrospective case series |
Villa et al. [5] | 2018 | 42 | 1996–2016 | Retrospective case series |
Bagan et al. [22] | 2019 | 63 | 2003–2018 | Retrospective observational clinical study |
Koh et al. [23] | 2019 | 10 | - | Case control |
Favia et al. [24] | 2020 | 75 | 1989–2008 | Retrospective case series |
Llorens et al. [25] | 2020 | 10 | - | Retrospective case control |
McParland and Warnakulasuriya [26] | 2020 | 51 | - | Retrospective case series |
Authors | Year of Publication | Grade of Recommendation | Quality of Evidence |
---|---|---|---|
Hansen et al. [2] | 1985 | 2A | C |
Zakrzewska et al. [7] | 1996 | 2A | C |
Silverman and Gorsky [8] | 1997 | 2A | C |
Schoelch et al. [9] | 1999 | 2A | C |
Fettig et al. [10] | 2000 | 2A | C |
Bagan et al. [11] | 2003 | 2A | B |
Bagan et al. [12] | 2004 | 2A | C |
Gandolfo et al. [13] | 2009 | 2A | B |
Poveda-Roda et al. [14] | 2010 | 2A | B |
Gouvea et al. [15] | 2013 | 2A | B |
Garcìa-Chìas et al. [16] | 2014 | 2A | C |
Flores et al. [17] | 2016 | 2A | B |
Garcìa-Pola et al. [18] | 2016 | 2A | C |
Borgna et al. [19] | 2016 | 2A | C |
Thomson et al. [20] | 2018 | 2A | B |
Upadhyaya et al. [21] | 2018 | 2A | C |
Villa et al. [5] | 2018 | 2A | C |
Bagan et al. [22] | 2019 | 2A | C |
Koh et al. [23] | 2019 | 2A | B |
Favia et al. [24] | 2020 | 2A | C |
Llorens et al. [25] | 2020 | 2A | B |
McParland and Warnakulasuriya [26] | 2020 | 2A | C |
Authors | Number of PVL Patients | M | F | Tobacco Use | Mean Follow-Up (Y) | Number of PVL Patients with Malignant Transformation | Number of Patients with Multiple Oral Cancers |
---|---|---|---|---|---|---|---|
Hansen 1985 [2] | 30 | 6 | 24 | 18 | 6.1 | 26/30 | - |
Zakrzewska 1996 [7] | 10 | 5 | 5 | 7 | 6.6 | 10/10 | - |
Silverman 1997 [8] | 54 | 11 | 43 | 17 | 11.6 | 38/54 | 12/38 |
Schoelch 1999 [9] | 12 | 4 | 8 | 5 | 4 | 2/12 | - |
Fettig 2000 [10] | 10 | 6 | 4 | 3 | 4.4 | 6/10 | - |
Bagan 2003/2004 [11,12] | 30 | 6 | 24 | 7 | 4.7 | 27/30 | 10/19 |
Gandolfo 2009 [13] | 47 | 10 | 37 | 17 | 6.8 | 19/47 | 8/19 |
Poveda-Roda 2010 [14] | 17 | 7 | 10 | 6 | 6.6 | 5/17 | 3/5 |
Gouvea 2013 [15] | 21 | 3 | 18 | 4 | 7.3 | 9/21 | 2/9 |
Garcìa-Chìas 2014 [16] | 40 | 15 | 25 | 13 | 3.6 | 7/40 | - |
Flores 2016 [17] | 15 | 0 | 15 | 0 | 5.4 | 4/15 | 2/4 |
Garcìa-Pola 2016 [18] | 14 | 3 | 11 | 3 | 14.5 | 4/14 | - |
Borgna 2016 [19] | 48 | 24 | 24 | 33 | 4.3 | 23/48 | - |
Thomson 2018 [20] | 80 | 41 | 39 | - | 4 | 2/80 | - |
Upadhyaya 2018 [21] | 20 | 6 | 14 | 12 | 7.6 | 9/20 | 3/9 |
Villa 2018 [5] | 42 | 7 | 35 | 17 | 4.5 | 30/42 | 10/30 |
Bagan 2019 [22] | 63 | 20 | 43 | 25 | 6 (median) | 30/63 | - |
Koh 2019 [23] | 10 | 5 | 5 | 6 | 3.3 | 4/10 | - |
Favia 2020 [24] | 75 | - | - | - | 5.2 (median) | 48/75 | 33/48 |
Llorens 2020 [25] | 10 | 4 | 6 | 3 | 12.2 | 6/10 | 4/6 |
McParland 2020 [26] | 51 | 25 | 26 | 22 | 16 | 11/51 | - |
Total | 699 | 208 | 416 | 218/544 | 7.2 | 320/699 | 87/187 |
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Palaia, G.; Bellisario, A.; Pampena, R.; Pippi, R.; Romeo, U. Oral Proliferative Verrucous Leukoplakia: Progression to Malignancy and Clinical Implications. Systematic Review and Meta-Analysis. Cancers 2021, 13, 4085. https://doi.org/10.3390/cancers13164085
Palaia G, Bellisario A, Pampena R, Pippi R, Romeo U. Oral Proliferative Verrucous Leukoplakia: Progression to Malignancy and Clinical Implications. Systematic Review and Meta-Analysis. Cancers. 2021; 13(16):4085. https://doi.org/10.3390/cancers13164085
Chicago/Turabian StylePalaia, Gaspare, Amelia Bellisario, Riccardo Pampena, Roberto Pippi, and Umberto Romeo. 2021. "Oral Proliferative Verrucous Leukoplakia: Progression to Malignancy and Clinical Implications. Systematic Review and Meta-Analysis" Cancers 13, no. 16: 4085. https://doi.org/10.3390/cancers13164085