Inquiry

Malignant transformation

Background

Oral squamous cell carcinoma (OSCC) accounts for the majority of head and neck squamous cell carcinomas, which as a group are considered aggressive. The occurrence of local and regional metastases may be the greatest contributor to the morbidity and mortality associated with OSCC. Late-stage diagnosis contributes to the low 5-year survival rates. The diagnosis and management of these lesions at the precancerous stage should improve survival rates. OSCC is usually preceded by tissue and cellular

Methods

Oral mucosal biopsies with a dysplastic or malignant diagnosis from a single Australian-based pathology laboratory were evaluated. Progression and malignant transformation were noted, as well as factors that appeared to be related to these changes.

Results

The mean age at diagnosis for the 368 patients was 59.5 years. Three hundred eighty-three biopsies demonstrated OED. Three pathologists, all with advanced training in oral and maxillofacial pathology, reported 58.7% of the results. Fifty-seven percent of the participants were men, and nearly 90% were over age 45 years. Dysplasia was found most often on the tongue, then the buccal mucosa. Nearly 60% of the cases were considered low-grade dysplasia.

Eleven lesions (10 patients) progressed to a

Discussion

The predictive value of grading systems for OED was assessed using long-term outcomes of dysplastic oral mucosal tissue lesions. About half of these lesions involved the tongue, and these were more likely to undergo malignant transformation. The buccal mucosa was the next most common location, which is also associated with high rates of oral mucosal lesions in other studies, but had no predilection for OED development in this analysis. Fewer than 5% of the OED cases underwent malignant