Oral Lichen Planus-Associated Oral Cavity Squamous Cell Carcinoma Is Associated With Improved Survival and Increased Risk of Recurrence

David L Best; Curtis Herzog; Corey Powell; Thomas Braun; Brent B Ward; Justine Moe

doi:10.1016/j.joms.2020.01.032

Oral Lichen Planus-Associated Oral Cavity Squamous Cell Carcinoma Is Associated With Improved Survival and Increased Risk of Recurrence

J Oral Maxillofac Surg. 2020 Jul;78(7):1193-1202. doi: 10.1016/j.joms.2020.01.032. Epub 2020 Feb 5.

Authors

David L Best¹, Curtis Herzog², Corey Powell³, Thomas Braun⁴, Brent B Ward⁵, Justine Moe⁶

Affiliations

¹ Resident, Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI.
² Dental Student, School of Dentistry, University of Michigan, Ann Arbor, MI.
³ Consultant, Department of Statistics, Computing, and Analytics Research, University of Michigan, Ann Arbor, MI.
⁴ Professor, Department of Biostatistics, University of Michigan, Ann Arbor, MI.
⁵ Section Head, Chair, and Associate Professor, Department of Oral and Maxillofacial Surgery; and Director, Oncology/Microvascular Surgery Fellowship, University of Michigan, Ann Arbor, MI.
⁶ Assistant Professor and Residency Program Director, Department of Oral and Maxillofacial Surgery; and Associate Director, Oncology/Microvascular Surgery Fellowship, University of Michigan, Ann Arbor, MI. Electronic address: [email protected].

PMID: 32114008
DOI: 10.1016/j.joms.2020.01.032

Abstract

Purpose: We investigated the overall survival (OS), disease-specific survival (DSS), and disease-free survival among patients with oral lichen planus-associated oral cavity squamous cell carcinoma (OLP-OCSCC). The secondary objective was to assess the annual risk of tumor recurrence or second primary tumor (SPT).

Materials and methods: A comparative retrospective study was performed of patients with OLP-OCSCC presenting between June 2007 and December 2018 to the Department of Oral and Maxillofacial Surgery, Michigan Medicine (Ann Arbor, MI) and patients with OCSCC in the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database (1973 to 2015).

Results: A total of 87 patients with OLP-OCSCC met the inclusion criteria, and 55,165 patients with OCSCC from the SEER database were included. The proportion of women was greater in the OLP group than in the SEER group (56.3 vs 38.0%; P < .001). In the OLP group, 47.1% had no smoking history and 43.7% had no alcohol history. Most patients in the OLP group had presented with stage I disease (46.0%) compared with 31.7% in the SEER group (P = .004). Overall, the OS and DSS were significantly greater in the OLP group than in the SEER group at all points from 1 to 5 years (P ≤ .01). In the OLP group, 46 patients (52.9%) had at least 1 recurrence or SPT. At 10 years, the predicted mean number of recurrences was 1.93 per patient (95% confidence interval, 1.56 to 2.39).

Conclusions: OLP-OCSCC frequently affects women, nonsmokers, and nondrinkers and presents with localized disease at a high frequency. Patients with OLP-OCSCC have increased OS and DSS and a greater risk of tumor recurrence or SPT compared with OCSCC in the general population. Lifelong, frequent surveillance is recommended for patients with OLP-OCSCC owing to the risk of late recurrence. Future studies are needed to understand the pathophysiology of OLP-OCSCC.

MeSH terms

Carcinoma, Squamous Cell*
Female
Head and Neck Neoplasms*
Humans
Lichen Planus, Oral*
Lichens*
Neoplasm Recurrence, Local
Retrospective Studies