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Malignant transformation risk of oral lichen planus: A systematic review and comprehensive meta-analysis. | LitMetric

AI Article Synopsis

  • The study aimed to assess the risk of cancer development from oral lichen planus (OLP), oral lichenoid lesions (OLLs), and oral lichenoid reactions (LRs) by reviewing existing research and identifying key influencing factors.
  • A total of 82 studies involving 26,742 patients were analyzed, revealing a low but significant malignant transformation rate of 1.14% for OLP, 1.88% for OLLs, and 1.71% for LRs.
  • Key risk factors for cancer development included tongue lesions, atrophic-erosive lesions, tobacco and alcohol use, and hepatitis C infection, with findings suggesting that current transformation rates may be underestimated due to strict diagnostic criteria and poor study quality

Article Abstract

Objectives: To evaluate current evidence on the malignant transformation of oral lichen planus (OLP), oral lichenoid lesions (OLLs), and oral lichenoid reactions (LRs) and to determine the variables with greatest influence on cancer development.

Material And Methods: We searched PubMed, Embase, Web of Science, and Scopus for studies published before November 2018. We evaluated the quality of studies (QUIPS tool). We carried out meta-analyses to fulfill our objectives. We examined the between-study heterogeneity and small-study effects, and conducted sensitivity studies and subgroup analyses.

Results: Inclusion criteria were met by 82 studies (26,742 patients. The combined malignant transformation rate was 1.14% for OLP (95% CI = 0.84-1.49), 1.88% for OLLs (95% CI = 0.15-4.95) and 1.71% for LRs (95% CI = 0.00-5.46). Subgroup analysis revealed a higher malignant transformation rate in studies when the presence of epithelial dysplasia was not an exclusion criterion (p = 0.001), when both clinical and histopathological criteria were used for diagnosis (p < 0.001), when the follow-up was at least 12 months (p = 0.048), and when there was lower risk of potential bias (p = 0.002). Malignant transformation risk factors were: tongue localization (RR = 1.82, 95% CI = 1.21-2.74, p = 0.004), presence of atrophic-erosive lesions (RR = 4.09, 95% CI = 2.40-6.98, p < 0.001), tobacco use (RR = 1.98, 95% CI = 1.28-3.05, p = 0.002), alcohol consumption (RR = 2.28, 95% CI = 1.14-4.56, p = 0.02), and hepatitis C virus infection (RR = 4.46, 95% CI = 0.98-20.22, p = 0.053).

Conclusions: The malignant transformation rates of OLP, OLLs and LRs are underestimated due essentially to restrictive diagnostic criteria, inadequate follow-up periods, and/or low quality of studies.

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Source
http://dx.doi.org/10.1016/j.oraloncology.2019.07.012DOI Listing

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