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Poster Award
Poster Award

Pathology

(65) Malignant Transformation of Oral Leukoplakia and its Clinicopathological Features in a Japanese Population

Thursday, September 18, 2025
2:30 PM - 4:00 PM EDT

    Poster Presenter(s)

  • Mitsuo Goto, DDS, PhD, FIBCSOMS

    Professor and Chair
    Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University
    Nagoya, Aichi, Japan

    • Co-Author(s)

  • SN

    Sanako Nakaya, DDS

    Resident and PhD Student
    Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University
    Nagoya, Aichi, Japan

  • KN

    Kensuke Naganawa, DDS, PhD

    Deputy Director
    Department of Oral and Maxillofacial Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital
    Nagoya, Aichi, Japan

  • Jun Sasaki, DDS, PhD

    Assistant Professor
    Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University
    Nagoya, Aichi, Japan

  • HF

    Hitoshi Fujii, DDS, PhD

    Assistant Professor
    Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University
    Nagoya, Aichi, Japan

  • FT

    Fumitaka Terasawa, DDS, PhD

    Assistant Professor
    Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University
    Nagoya, Aichi, Japan

  • SM

    Satoru Miyabe, DDS, PhD

    Assistant Professor
    Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University
    Nagoya, Aichi, Japan

  • SW

    Satoshi Watanabe, DDS, PhD

    Associate Professor
    Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University
    Nagoya, Aichi, Japan

  • SH

    Shogo Hasegawa, DDS, PhD

    Associate Professor
    Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University
    Nagoya, Aichi, Japan

  • HM

    Hitoshi Miyachi, DDS, PhD

    Associate Professor
    Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University
    Nagoya, Aichi, Japan

Disclosure(s):
Mitsuo Goto, DDS, PhD, FIBCSOMS: No financial relationships to disclose
Abstract:
Background and

Purpose: This study investigated the clinical features and malignant transformation (MT) rates of oral leukoplakia (OL) in a Japanese population. We also investigated the impact of clinical risk factors and pathological features on MT to improve the quality of care for patients with OL, including the diagnostic accuracy and early detection of MT.
Materials and

Methods: This retrospective study included 231patients diagnosed with OL between 1989 and 2020 at our department. The time to MT was calculated from the date of the initial diagnosis which may or may not have been histologically confirmed by certified oral and maxillofacial surgeons to the date of oral squamous cell carcinoma (OSCC) diagnosis confirmed by biopsy. The Kaplan−Meier method was employed to analyze 5- and 10-year risks of developing OSCC. Chi-square test and multiple regression models were used to investigate predictors of progression to OSCC.

Results: The mean age of the patients was 62.6 years, and 45.9% were female. The most common site of OL was the tongue (36.4%), followed by the gingiva (34.6%) and buccal mucosa (19.5%). Twenty patients (8.7%) experienced MT to OSCC, and the 5- and 10-year risks of MT were 7.8% and 12.7%, respectively. Univariate analysis showed that age, tongue lesions, nonhomogeneous type, and biopsy performed at initial diagnosis were significant risk factors. Moreover, the nonhomogeneous type was influential risk factor in multivariate analysis. The numbers of female nonsmokers and nondrinkers were significantly higher among the MT cases (P = .0016, P = .0373, respectively). The histopathological data of the biopsy cases with MT showed that the highest percentage (28.6%) was observed in moderate dysplasia at the time of initial diagnosis. Moreover, immunohistochemical analyses showed that podoplanin expression was observed in 64.3% cases undergoing biopsy.

Conclusions: OL increases the risk of MT due to a combination of clinicopathological risk factors. Therefore, high-risk cases require shorter follow-up intervals and careful observation. Performing biopsies to identify histopathological factors and make a definitive diagnosis should be considered.

References:
1. Aguirre-Urizar JM, Lafuente-Ibáñez de Mendoza I, Warnakulasuriya S. Malignant transformation of oral leukoplakia: Systematic review and meta-analysis of the last 5 years. Oral Dis 2021;27:1881–95.
2. Birkeland AC, Kademani D, Moore MG, Blair EA. Practice patterns for initial management of oral leukoplakia amongst otolaryngologists and oral and maxillofacial surgeons. Oral Oncol 2023;139:106341.