Head & neck · 2017
Management of proliferative verrucous leukoplakia: Justification for a conservative approach.
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Borgna Scott C, Clarke Peter T, Schache Andrew G, Lowe Derek, Ho Michael W, McCarthy Caroline E, Adair Stephen, Field E Anne, Field John K, Holt Deborah, Risk Janet M, Rajlawat Bijay P, Triantafyllou Asterios, Shaw Richard J
Аннотация
BACKGROUND: Proliferative verrucous leukoplakia (PVL) is a progressive, multifocal, exophytic form of leukoplakia with high rates of malignant transformation. The purpose of this study was to evaluate a cohort of patients with PVL in a single tertiary referral clinic.
METHOD: Cases meeting accepted diagnostic criteria were reviewed with regard to their pathology, demographic characteristics, management, and outcomes. Human papillomavirus (HPV) testing was undertaken on a subset.
RESULTS: Almost half of the 48 patients with PVL (48%; n = 23) underwent malignant transformation after a median 23.4 months. The characteristics of this cohort were similar to those previously described, but management was notably more conservative. Conservative management of PVL was used in 92% of our patients, but the clinical outcomes seem comparable with previously described cohorts in which PVL was predominantly treated by surgical excision. All HPV testing was negative.
CONCLUSION: Aggressive surgical intervention in the premalignant phase of PVL may not influence the rate of malignant transformation.
METHOD: Cases meeting accepted diagnostic criteria were reviewed with regard to their pathology, demographic characteristics, management, and outcomes. Human papillomavirus (HPV) testing was undertaken on a subset.
RESULTS: Almost half of the 48 patients with PVL (48%; n = 23) underwent malignant transformation after a median 23.4 months. The characteristics of this cohort were similar to those previously described, but management was notably more conservative. Conservative management of PVL was used in 92% of our patients, but the clinical outcomes seem comparable with previously described cohorts in which PVL was predominantly treated by surgical excision. All HPV testing was negative.
CONCLUSION: Aggressive surgical intervention in the premalignant phase of PVL may not influence the rate of malignant transformation.