Evaluating surgical excision to prevent progression of oral precancerous lesions: Highlighting randomized controlled trials and cohort studies

Currently, surgical excision remains a common intervention for oral precancerous lesions (OPL). However, the studies focusing on conventional surgery by scalpel for OPL are not analyzed collectively in detail. Therefore, the objective of this short communication is to summarize and evaluate the evid...

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Main Authors: Shanxin Zhou, Xinyu Zhang, Wei Liu, Weishi Chen
Format: Article
Language:English
Published: Elsevier 2023-10-01
Series:Journal of Dental Sciences
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1991790223001708
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author Shanxin Zhou
Xinyu Zhang
Wei Liu
Weishi Chen
author_facet Shanxin Zhou
Xinyu Zhang
Wei Liu
Weishi Chen
author_sort Shanxin Zhou
collection DOAJ
description Currently, surgical excision remains a common intervention for oral precancerous lesions (OPL). However, the studies focusing on conventional surgery by scalpel for OPL are not analyzed collectively in detail. Therefore, the objective of this short communication is to summarize and evaluate the evidence on scalpel surgery in preventing the progression of OPL patients. There are 16 eligible studies on surgery management of the recurrence (13 studies) or malignant transformation (13 studies) of OPL. The pooled recurrence rate (95% confidence interval) of OPL patients received scalpel surgery and laser therapy is 29.5% (26.3–33.0%) and 32.2% (26.1–38.9%), respectively. The pooled rate of malignant transformation of OPL patients received scalpel surgery, laser therapy, and clinical observation is 8.9% (7.3–10.9%), 6.0% (3.5–10.1%), and 10.2% (8.6–12.1%), respectively. The important limitation of current evidence available for prognosis of dysplastic OPL is based on retrospective observational studies. It highlights that surgical management of OPL needs more randomized controlled trials and cohort studies to explore more reliable methods for routine clinical use to facilitate high- or low-risk stratification and further select more appropriate treatment option.
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spelling doaj.art-441939966a764e2fa6983a99c3bc459c2023-09-27T04:42:28ZengElsevierJournal of Dental Sciences1991-79022023-10-0118418761882Evaluating surgical excision to prevent progression of oral precancerous lesions: Highlighting randomized controlled trials and cohort studiesShanxin Zhou0Xinyu Zhang1Wei Liu2Weishi Chen3Department of Stomatology, The First Affiliated Hospital of Ningbo University, Zhejiang, ChinaDepartment of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Center of Head and Neck Oncology Clinical and Translational Science, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, ChinaDepartment of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Center of Head and Neck Oncology Clinical and Translational Science, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China; Corresponding author. Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, 500 Quxi Road, Shanghai, 200011, China.Department of Stomatology, The First Affiliated Hospital of Ningbo University, Zhejiang, China; Corresponding author. Department of Stomatology, The First Affiliated Hospital of Ningbo University, 247 Renmin Road, Ningbo, 315020, China.Currently, surgical excision remains a common intervention for oral precancerous lesions (OPL). However, the studies focusing on conventional surgery by scalpel for OPL are not analyzed collectively in detail. Therefore, the objective of this short communication is to summarize and evaluate the evidence on scalpel surgery in preventing the progression of OPL patients. There are 16 eligible studies on surgery management of the recurrence (13 studies) or malignant transformation (13 studies) of OPL. The pooled recurrence rate (95% confidence interval) of OPL patients received scalpel surgery and laser therapy is 29.5% (26.3–33.0%) and 32.2% (26.1–38.9%), respectively. The pooled rate of malignant transformation of OPL patients received scalpel surgery, laser therapy, and clinical observation is 8.9% (7.3–10.9%), 6.0% (3.5–10.1%), and 10.2% (8.6–12.1%), respectively. The important limitation of current evidence available for prognosis of dysplastic OPL is based on retrospective observational studies. It highlights that surgical management of OPL needs more randomized controlled trials and cohort studies to explore more reliable methods for routine clinical use to facilitate high- or low-risk stratification and further select more appropriate treatment option.http://www.sciencedirect.com/science/article/pii/S1991790223001708Malignant transformationOral epithelial dysplasiaOral potentially malignant disordersOral squamous cell carcinomaSurgical treatment
spellingShingle Shanxin Zhou
Xinyu Zhang
Wei Liu
Weishi Chen
Evaluating surgical excision to prevent progression of oral precancerous lesions: Highlighting randomized controlled trials and cohort studies
Journal of Dental Sciences
Malignant transformation
Oral epithelial dysplasia
Oral potentially malignant disorders
Oral squamous cell carcinoma
Surgical treatment
title Evaluating surgical excision to prevent progression of oral precancerous lesions: Highlighting randomized controlled trials and cohort studies
title_full Evaluating surgical excision to prevent progression of oral precancerous lesions: Highlighting randomized controlled trials and cohort studies
title_fullStr Evaluating surgical excision to prevent progression of oral precancerous lesions: Highlighting randomized controlled trials and cohort studies
title_full_unstemmed Evaluating surgical excision to prevent progression of oral precancerous lesions: Highlighting randomized controlled trials and cohort studies
title_short Evaluating surgical excision to prevent progression of oral precancerous lesions: Highlighting randomized controlled trials and cohort studies
title_sort evaluating surgical excision to prevent progression of oral precancerous lesions highlighting randomized controlled trials and cohort studies
topic Malignant transformation
Oral epithelial dysplasia
Oral potentially malignant disorders
Oral squamous cell carcinoma
Surgical treatment
url http://www.sciencedirect.com/science/article/pii/S1991790223001708
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