Clinical guidelines in early detection of oral squamous cell carcinoma arising in oral lichen planus: a 5-year experience

In recent years, studies on the malignant potential of oral lichen planus ( OLP) provided clinical evidence that patients affected by OLP have an incre ased risk to develop oral squamous cell carcinoma (OSCC); nevertheless, con troversies still exist as to whether OLP has inherent predisposition to bec ome malignant, or not. We believe extremely careful management of OLP patie nt is mandatory, and the aim of this paper is to illustrate our clinical gu idelines in evaluating the possible risk of transformation in OLP Lesions. Five-hundred and two patients (311 women and 191 men) affected by OLP regul arly undergo follow-up examination in our Department. Patients' ages range from 18 to 83 years, with a mean of 55.4 years (57.5 for women and 53.9 for men); minimal follow-up period is 4 months, with a maximum of 12 years. In our group of OLP patients in the past 5 years we detected 24 carcinomas: e xcluding three cases in which diagnoses of OLP and OSCC were synchronous an d three patients who had a history of tobacco use, thus possible malignant transformation of OLP would appear to be 3.7%. Clinical criteria used in ou r follow-up allowed us to detect 28.5% of tumours as in situ OSCC, 38% as m icroinvasive OSCC, 28.5% as stage I OSCC and 3.7% as stage ZI OSCC, with a remarkable improvement in prognosis compared to our previous study in which we adopted different criteria. (C) 2001 Elsevier Science Ltd. All rights r eserved.