Prognosis Parameters of Oral Carcinomas Developed in Proliferative Verrucous Leukoplakia: A Systematic Review and Meta-Analysis
Metadatos
Mostrar el registro completo del ítemEditorial
MDPI
Materia
Malignant transformation Meta-analysis Oral cancer Prognosis Proliferative verrucous leukoplakia Systematic review
Fecha
2021-09-28Referencia bibliográfica
González-Moles, M.Á.; Warnakulasuriya, S.; Ramos-García, P. Prognosis Parameters of Oral Carcinomas Developed in Proliferative Verrucous Leukoplakia: A Systematic Review and Meta- Analysis. Cancers 2021, 13, 4843. [https://doi.org/10.3390/cancers13194843]
Patrocinador
Junta de Andalucia CTS-392Resumen
Proliferative verrucous leukoplakia (PVL) is contemplated by the World Health Organization
(WHO) as an oral potentially malignant disorder (OPMD) with a high the highest malignant
transformation ratio among all OPMD (approximately 50%). Our aim was to evaluate the current
evidence in relation to the prognosis of oral carcinoma developed in patients with proliferative
verrucous leukoplakia (PVL-OC). We searched PubMed, Embase, Web of Science and Scopus for
published studies (upper date limit = June 2021). We evaluated the quality of studies (QUIPS tool).
We carried out meta-analyses, examined inter-study heterogeneity through subgroup and metaregression
analyses, and performed sensitivity and small-study effects analyses to test the stability
and reliability of results. 23 studies met inclusion criteria (505 patients with PVL, of which 288
developed a total of 504 carcinomas). The meta-analyzed overall mortality rate was 21.29% (pooled
proportions [PP] = 95% confidence intervals [CI] = 8.77–36.36) for PVL-OC, clearly lower than the
34.7–50% mortality rate for conventional oral cancer reported in previous studies. In comparison with
a single study reporting on conventional oral cancers, mortality was significantly lower for PVL-OC
(hazard ratio = 0.29 [95%CI = 0.10–0.89], p = 0.03). Univariable meta-regression verified that case
series that presented higher proportions of verrucous carcinomas showed a better survival of PVL-OC
(p = 0.05), but not with higher proportion of oral squamous cell carcinomas (p = 0.74). Significant
differences were not found for other relevant variables such as follow up period (p = 0.44) or multiple
tumor development (p = 0.74). In conclusion, PVL-OC show favorable prognostic parameters,
especially with regard to the mortality rate.