Lorini Luigi, Tomasoni Michele, Gurizzan Cristina, Magri Chiara, Facchetti Mattia, Battocchio Simonetta, Romani Chiara, Ravanelli Marco, Oberti Arianna, Bozzola Anna, Bardellini Elena, Paderno Alberto, Mattavelli Davide, Lombardi Davide, Grammatica Alberto, Deganello Alberto, Facchetti Fabio, Calza Stefano, Majorana Alessandra, Piazza Cesare, Bossi Paolo
Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, Brescia, Italy.
Otorhinolaryngology-Head and Neck Surgery Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, Brescia, Italy.
Front Oncol. 2022 Apr 21;12:886404. doi: 10.3389/fonc.2022.886404. eCollection 2022.
Oral potentially malignant disorders (OPMDs) represent a heterogeneous set of different histological lesions, characterized by the capacity to transform in oral squamous cell carcinoma (OSCC). Despite optimal surgical treatment, approximately 20%-30% of OPMDs may evolve into OSCC. No clear clinical/histological factors are able to identify OPMDs at higher risk of malignant transformation.
We considered surgically treated patients with a diagnosis of OPMDs, enrolled from 1996 to 2019 at ASST Spedali Civili of Brescia without a diagnosis of OSCC within the previous 2 years. Clinical and histological characteristics were recorded. Outcomes of interest were recurrence-free survival (RFS), defined as the time from surgery for primary OPMD to any relapse of OPMD or malignant transformation, whichever occurred first, and carcinoma-free survival (CFS), defined as the time from surgery for OPMD to malignant transformation.
We retrospectively reviewed 106 OPMDs cases. Median age at first diagnosis was 64 years old (IQR = 18.75); female patients comprise 51.9% of the cases. During a median follow-up of 30.5 months (IQR = 44), in 23.5% of patients, malignant transformation occurred. RFS at 1, 5, and 10 years was 92.4%, 60.9%, and 43.2%, respectively. Female sex and history of previous OSCC were independent risk factors for RFS. CFS at 1, 5, and 10 years of follow-up was 97.1%, 75.9%, and 64.4%, respectively. Previous OSCC was an independent risk factor for CFS.
In this large series of OPMDs, only previous diagnosis of OSCC was a prognostic factor for further OSCC occurrence. Given the lack of additional clinical/pathological prognostic factors, we advocate further studies into molecular characterization of OPMDs to better stratify the risk of malignant transformation.
口腔潜在恶性疾病（OPMDs）是一组组织学表现各异的病变，其特征是有转化为口腔鳞状细胞癌（OSCC）的能力。尽管采取了最佳手术治疗，但约20%-30%的OPMDs可能会演变为OSCC。目前尚无明确的临床/组织学因素能够识别具有较高恶性转化风险的OPMDs。
我们纳入了1996年至2019年在布雷西亚市立医院接受手术治疗且诊断为OPMDs、前两年内未诊断为OSCC的患者。记录其临床和组织学特征。感兴趣的结局指标为无复发生存期（RFS），定义为从原发性OPMD手术至OPMD复发或恶性转化（以先发生者为准）的时间，以及无癌生存期（CFS），定义为从OPMD手术至恶性转化的时间。
我们回顾性分析了106例OPMDs病例。首次诊断时的中位年龄为64岁（四分位间距 = 18.75）；女性患者占病例总数的51.9%。在中位随访30.5个月（四分位间距 = 44）期间，23.5%的患者发生了恶性转化。1年、5年和10年的RFS分别为92.4%、60.9%和43.2%。女性性别和既往OSCC病史是RFS的独立危险因素。随访1年、5年和10年的CFS分别为97.1%、75.9%和64.4%。既往OSCC是CFS的独立危险因素。
在这一大型OPMDs队列中，只有既往OSCC诊断是进一步发生OSCC的预后因素。鉴于缺乏其他临床/病理预后因素，我们主张进一步研究OPMDs的分子特征，以更好地分层恶性转化风险。
