Clinical Management Update of Oral Leukoplakia: A Review From the American Head and Neck Society Cancer Prevention Service

James C Gates; Marianne Abouyared; Yelizaveta Shnayder; D Gregory Farwell; Andrew Day; Faizan Alawi; Michael Moore; Andrew J Holcomb; Andrew Birkeland; Joel Epstein

doi:10.1002/hed.28013

Clinical Management Update of Oral Leukoplakia: A Review From the American Head and Neck Society Cancer Prevention Service

Head Neck. 2024 Nov 25. doi: 10.1002/hed.28013. Online ahead of print.

Authors

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
² Department of Otolaryngology-Head and Neck Surgery, UC Davis Health, Sacramento, California, USA.
³ Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas, USA.
⁴ Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania and Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
⁵ Department of Otolaryngology, UT Southwestern Medical Center, Dallas, Texas, USA.
⁶ Department of Oral and Maxillofacial Pathology, Penn Dental Medicine and Department of Cutaneous Biology, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁷ Department of Otolaryngology- Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
⁸ Department of Head & Neck Surgical Oncology, Estabrook Cancer Center, Nebraska Methodist Hospital, Omaha, Nebraska, USA.
⁹ Department of Otolaryngology- Head and Neck Surgery, UC Davis Health, Sacramento, California, USA.
¹⁰ Department of Surgery, Cedars-Sinai Health System, Los Angeles, California, USA.
¹¹ City of Hope Comprehensive Cancer Center, Duarte, California, USA.

PMID: 39584361
DOI: 10.1002/hed.28013

Abstract

Background: Oral potentially malignant disorders (OPMDs) occur in up to 4%-5% of the population, of which oral leukoplakia (OL) is the most common subtype. Predicting high-risk OL remains a challenge. Early diagnosis and effective treatment are thought to be of paramount importance to improve outcomes.

Methods: We searched PubMed and Clinicaltrials.gov data for updates in the clinical management of OL from 2015 to current.

Results: Recent publication of large cohorts of patients with OL aids in counseling patients regarding risk of malignant transformation. Management for OL includes surveillance, excision, and laser surgery, as well as local and systemic approaches to chemoprevention. Several new entities show promise regarding candidate biomarkers, chemoprevention agents, and diagnostic adjuncts, though all require further validation.

Conclusion: This update serves to further inform clinical management of OL and provide impetus for future investigations.

Trial registration: NCT00099021, NCT00951379, NCT05727761, NCT05727761.

Keywords: dysplasia; oral cancer; oral carcinogenesis; oral leukoplakia; oral premalignant disease.

Publication types

Review

Associated data

ClinicalTrials.gov/NCT00951379
ClinicalTrials.gov/NCT00099021
ClinicalTrials.gov/NCT05727761