The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
I Van Der Waal - One of the best experts on this subject based on the ideXlab platform.
-
Malignant Transformation of oral leukoplakia in a well defined cohort of 144 patients
Oral Diseases, 2014Co-Authors: E R E A Brouns, J A Baart, K H Karagozoglu, I H A Aartman, Elisabeth Bloemena, I Van Der WaalAbstract:Objectives Oral leukoplakia is a potentially Malignant disorder of the oral mucosa. The aim of this retrospective study was to identify the factors that possibly predict Malignant Transformation in a well-defined cohort of patients with a long-term follow-up. All leukoplakias were staged according to a clinicopathological classification and staging system. Furthermore, a certainty factor has been used with which the diagnosis has been established. Material and methods The group consisted of 144 patients. The size, presence and degree of epithelial dysplasia were incorporated into a clinicopathological classification and staging system. Initial management consisted of surgical excision, CO2 laser vaporisation or observation only. The mean follow-up period was 51.2 months (s.d. = 39.33, range 12-179 months). Results In 16 of 144 patients (11%), Malignant Transformation occurred between 20 and 94 months (mean 57.0 months) after the first visit, the annual Malignant Transformation rate being approximately 2.6%. A large size of the lesion (≥ 4 cm) showed to be the only statistically significant predictor of Malignant Transformation (P = 0.034). Conclusion A size of ≥ 4 cm showed to be the only significant predicting factor of Malignant Transformation in oral leukoplakia. No other epidemiological, aetiological, clinical or histopathological parameters were of statistical significance.
-
Malignant Transformation of oral leukoplakia a follow up study of a hospital based population of 166 patients with oral leukoplakia from the netherlands
Oral Oncology, 1998Co-Authors: K P Schepman, E H Van Der Meij, L E Smeele, I Van Der WaalAbstract:A follow-up study of a hospital-based population of 166 patients with oral leukoplakia revealed a 2.9% annual Malignant Transformation rate. The median follow-up period was 29 months. Parameters associated with an increased risk of Malignant Transformation were female gender (P < 0.025), absence of smoking habits in women (P < 0.05), and a non-homogeneous clinical aspect (P = 0.01). For uniform reporting, a recently proposed classification and staging system has been used. Leukoplakias in stage IV, consisting of lesions with moderate or severe epithelial dysplasia, were associated with an increased risk of Malignant Transformation (P < 0.01). There were no oral subsites associated with an increased risk. Patients who had any form of intervention did not have a statistically significantly lower chance for Malignant Transformation than patients who were kept under surveillance without intervention.
Jose Antonio Gilmontoya - One of the best experts on this subject based on the ideXlab platform.
-
Malignant Transformation risk of oral lichen planus a systematic review and comprehensive meta analysis
Oral Oncology, 2019Co-Authors: Miguel Angel Gonzalezmoles, Jose Antonio Gilmontoya, Isabel Ruizavila, Lucia Gonzalezruiz, Angela Ayen, Pablo RamosgarciaAbstract: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 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.
-
oral lichen planus controversies surrounding Malignant Transformation
Oral Diseases, 2008Co-Authors: Miguel Angel Gonzalezmoles, Crispian Scully, Jose Antonio GilmontoyaAbstract:: Studies of the Malignant potential of oral lichen planus (OLP) have been hampered by inconsistencies in the diagnostic criteria used for OLP, the criteria adopted to identify a true case of Malignant Transformation in OLP, the risk factors for Malignant Transformation and the optimum management of patients to ensure the early diagnosis of Transformation. Consensus remains elusive, and leading workers in this field have recently published conflicting reports on the Malignant potential of OLP and on the important question of the advisability of excluding patients with epithelial dysplasia or a tobacco habit from studies on this issue. The present review outlines these debates and proposes a possible a molecular basis for the Malignant Transformation in this disease.
Miguel Angel Gonzalezmoles - One of the best experts on this subject based on the ideXlab platform.
-
Malignant Transformation risk of oral lichen planus a systematic review and comprehensive meta analysis
Oral Oncology, 2019Co-Authors: Miguel Angel Gonzalezmoles, Jose Antonio Gilmontoya, Isabel Ruizavila, Lucia Gonzalezruiz, Angela Ayen, Pablo RamosgarciaAbstract: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 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.
-
oral lichen planus controversies surrounding Malignant Transformation
Oral Diseases, 2008Co-Authors: Miguel Angel Gonzalezmoles, Crispian Scully, Jose Antonio GilmontoyaAbstract:: Studies of the Malignant potential of oral lichen planus (OLP) have been hampered by inconsistencies in the diagnostic criteria used for OLP, the criteria adopted to identify a true case of Malignant Transformation in OLP, the risk factors for Malignant Transformation and the optimum management of patients to ensure the early diagnosis of Transformation. Consensus remains elusive, and leading workers in this field have recently published conflicting reports on the Malignant potential of OLP and on the important question of the advisability of excluding patients with epithelial dysplasia or a tobacco habit from studies on this issue. The present review outlines these debates and proposes a possible a molecular basis for the Malignant Transformation in this disease.
Eman Ahmed - One of the best experts on this subject based on the ideXlab platform.
-
Malignant Transformation of oral lichen planus and oral lichenoid lesions a meta analysis of 20095 patient data
Oral Oncology, 2017Co-Authors: Sana Maher Hasan Aghbari, Abdelrahman Ibrahim Abushouk, Attia Attia, Ahmed Elmaraezy, Amr Menshawy, Mohamed Shehata Ahmed, Basma Elsaadany, Eman AhmedAbstract:Abstract Objectives For over a century, a heated debate existed over the possibility of Malignant Transformation of oral lichen planus (OLP). We performed this meta-analysis to evaluate the Malignant potential of OLP and oral lichenoid lesions (OLL) and investigate the possible risk factors for OLP Malignant Transformation into oral squamous cell carcinoma (OSCC). Materials and methods We searched Medline, Scopus, and Web of Knowledge for relevant observational studies. Data on OLP Malignant Transformation were calculated as a pooled proportion (PP), using the Der-Simonian Liard method. We performed subgroup analyses by OLP diagnostic criteria, site, and clinical type, using Open Meta[Analyst] software. Data on possible risk factors for Malignant Transformation were pooled as odds ratios (ORs), using Comprehensive Meta-Analysis software. Results Pooling data for OLP Malignant Transformation from 57 studies (19,676 patients) resulted in an overall PP of 1.1% [95% CI: 0.9%, 1.4%], while pooling data from 14 recent studies that used the World Health Organization-2003 diagnostic criteria resulted in an overall-PP of 0.9% [95% CI: 0.5%, 1.3%]. The risk of Malignant Transformation was higher (PP = 2.5%, 95% CI [1%, 4%]) in OLL patients (419 patients). A significant increase of Malignant Transformation risk was noted among smokers (OR = 2, 95% CI [1.25, 3.22]), alcoholics (OR = 3.52, 95% CI [1.54, 8.03]), and HCV-infected patients (OR = 5, 95% CI [1.56, 16.07]), compared to patients without these risk factors. Conclusion A small subset of OLP patients (1.1%) develop OSCC; therefore, regular follow-up for these patients is recommended. A higher incidence of Malignant Transformation was found among smokers, alcoholics, and HCV-infected patients; however, these associations should be further investigated.
Janet M Risk - One of the best experts on this subject based on the ideXlab platform.
-
the clinical determinants of Malignant Transformation in oral epithelial dysplasia
Oral Oncology, 2012Co-Authors: Janet M Risk, Julia A Woolgar, E A Field, John K Field, J C Steele, B P Rajlawat, Asterios Triantafyllou, Simon N Rogers, D LoweAbstract:Summary Background While the size and clinical appearance are known risk factors for Malignant Transformation of potentially Malignant oral the importance of site, grade of dysplasia and exposure to environmental carcinogens remains controversial. We aim to report the clinical determinants of Malignant progression in a series of patients with histopathologically graded oral epithelial dysplasia (OED). Methods We recruited patients with a histopathological diagnosis of OED to a longitudinal observational study in a tertiary oral dysplasia clinic. Clinical, histopathological and risk factor data were recorded at baseline. One of three clinical endpoints were determined: Malignant Transformation, progression of dysplasia grade, remission/stable dysplasia grade. Results Ninety-one patients meeting the criteria gave consent for inclusion to the cohort, with outcomes reported after a median follow up of 48 months. An estimated 22% (SE 6%) of patients underwent Malignant Transformation within 5 years, with significant predictors being: non-smoking status (χ2 = 15.1, p = 0.001), site (χ2 = 15.3, p = 0.002), non-homogeneous appearance (χ2 = 8.2, p = 0.004), size of lesion >200 mm2 (χ2 = 4.7, p = 0.03) and, of borderline significance, high grade (χ2 = 5.8, p = 0.06). Gender, age, number of lesions and alcohol history did not predict for Malignant Transformation. Conclusions Although a number of these clinical determinants have previously been associated with higher Malignant Transformation in OED, the high-risk nature of lesions in non-smokers is of particular note and requires a greater emphasis and recognition amongst clinicians dealing with OED. It suggests that those non-smokers with OED, have an inherited or acquired predisposition and should be treated more aggressively; these should form the focus for further investigation.
-
p16 promoter methylation is a potential predictor of Malignant Transformation in oral epithelial dysplasia
Cancer Epidemiology Biomarkers & Prevention, 2008Co-Authors: Gillian L Hall, Julia A Woolgar, John K Field, Simon N Rogers, D Lowe, Richard Shaw, Anne E Field, D N Sutton, Triantafillos Liloglou, Janet M RiskAbstract:Management of the patient with oral epithelial dysplasia depends on the ability to predict Malignant Transformation. Histologic grading of this condition fails in this regard and is also subject to interpathologist and intrapathologist variability. This study uses longitudinal clinical samples to explore the prognostic value of a previously validated panel of methylation biomarkers in a cohort of patients with histologically proven oral dysplasia. Methylation enrichment pyrosequencing assays were used to provide the sensitivity of traditional methylation-specific PCR with the additional specificity advantages of a subsequent confirmatory sequencing reaction. In 57% (8 of 14) patients with a lesion that transformed to oral squamous cell carcinoma, 26% (26 of 100) of longitudinal samples collected over > or =3 years showed p16 methylation. Only 1% (2 of 184) of samples from 8% of patients (2 of 24) not undergoing Malignant Transformation within 3 years had p16 methylation. Both of these samples with p16 promoter methylation were the most recently collected and the patients remain under continuing clinical review. Promoter methylation of MGMT, CYGB, and CCNA1 did not correlate with Malignant progression. We thus conclude that methylation of the p16 gene promoter shows promise as a predictor for Malignant Transformation (Fisher's exact, P = 0.002) in a subset of patients.