Laser excision of oral leukoplakia: Does it affect recurrence and malignant transformation? A systematic review and meta-analysis

Mariana de Pauli Paglioni; Cesar Augusto Migliorati; Isabel Schausltz Pereira Faustino; Bruno Augusto Linhares Almeida Mariz; Ana Luiza Oliveira Corrêa Roza; Pablo Agustin Vargas; Adriana Franco Paes Leme; Thaís Bianca Brandão; Ana Carolina Prado Ribeiro; Marcio Ajudarte Lopes; Alan Roger Santos-Silva

doi:10.1016/j.oraloncology.2020.104850

Laser excision of oral leukoplakia: Does it affect recurrence and malignant transformation? A systematic review and meta-analysis

Oral Oncol. 2020 Jun 12:109:104850. doi: 10.1016/j.oraloncology.2020.104850. Online ahead of print.

Affiliations

¹ Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil. Electronic address: marianapaglioni@hotmail.com.
² College of Dentistry, University of Florida, Gainesville, FL, USA.
³ Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
⁴ Brazilian Biosciences National Laboratory, LNBio, CNPEM, Campinas, Brazil.
⁵ São Paulo Cancer Institute (ICESP), Dentistry Department, São Paulo, Brazil.

PMID: 32540612
DOI: 10.1016/j.oraloncology.2020.104850

Abstract

Oral leukoplakia (OL) is a white lesion with high potential of recurrence and malignant transformation. The variable clinical and histopathological features of OL may potentially impact both treatment and prognosis. Current literature shows that post treatment rates of recurrence and malignant transformation vary widely. The use of surgical lasers have been proposed with the objective of improving outcomes. We performed a systematic review and a comprehensive meta-analysis dedicated to pooling the rates of recurrence and malignant transformation of OL lesions treated using the main types of surgical lasers available. Scopus, MEDLINE/PubMed, and Embase were searched electronically. A total of 36 articles met the inclusion criteria. Selected studies included OL lesions that were treated by evaporation or excision using Nd:YAG laser, Er:YAG laser, CO₂ laser, KTP laser, or diode laser. The results of this systematic review and meta-analysis suggest that surgical laser excision of OL may decrease recurrence rates but have no effect on the malignant transformation of OL when compared with conventional treatments.

Keywords: Laser; Laser surgery; Leukoplakia; Meta-analysis; Oral leukoplakia; Prognosis; Recurrence; Systematic review; Treatment outcome.

Publication types

Review