Malignant transformation in patients with oral lichen planus


This cohort study of 327 oral lichen planus (OLP) patients; 229 women (70.0%) and 98 men (30.0%), was conducted using data from a cohort of caucasian patients from Italy with clinical and pathologic diagnosis of OLP, according to revised and modified World Health Organization diagnostic criteria.

Follow-up of the patient cohort was started 6 months after OLP diagnosis with a mean follow-up of 81.7 months.

They found that:-

  • Eight of the 327 patients developed an oral squamous cell carcinoma (OSCC) in OLP areas (0.36%/y).  A high overall standardized incidence ratio of 17.7 (95% confidence interval [CI] 8.8-35.3).
  • The standardized incidence ratio for OSCC was significantly higher in women [27.0 (95% CI 11.2-64.8)] than in men [11.2 (95% CI 3.6-34.9)].
  • Six OSCCs were well differentiated (75%) and 2 moderately differentiated (25%).
  • Three subjects (37.5%) developed a OSCC recurrence within 2 years (mean 16.1 ± 3.5 months).

They concluded

OLP was associated with a significant increase in the risk for OSCC. Close surveillance may help to reduce the morbidity of OSCC arising from OLP at 24 months.

Bombeccari GP, Guzzi G, Tettamanti M, Giannì AB, Baj A, Pallotti F, Spadari F. Oral lichen planus and malignant transformation: a longitudinal cohort study.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Jul 20. [Epub ahead ofprint] PubMed PMID: 21782485.

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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