PROLIFERATIVE VERRUCOUS LEUKOPLAKIA - A FOLLOW-UP-STUDY OF 54 CASES

Objectives, Proliferative verrucous leukoplakia is a unique form of or al leukoplakia that has a high risk for becoming dysplastic and transf orming into squamous cell carcinoma. The purpose of this review is to update patient profiles, pathogenesis, and survival. Study design, Fif ty-four patients with proliferative verrucous leukoplakia (17 from a p revious report) were followed prospectively in our clinic for a mean o f 11.6 years after initial biopsy. Results, In the patient population studied, the mean age was 62 years. and women outnumbered men 4 to 1, Multiple intraoral sites were involved (mean, 2.6 per patient); the mo st common sites were buccal mucosa in women and tongue in men. In a me an time of 7.7 years, 70.3% of the patients developed a squamous cell carcinoma at a proliferative verrucous leukoplakia site, most frequent ly the gingiva and tongue. Twenty-one of the patients with proliferati ve verrucous leukoplakia died of proliferative verrucous leukoplakia-a ssociated carcinoma. Only 31% of the 54 patients used tobacco in any f orm, Radiation did not appear to enhance surgical control. Conclusions , Proliferative verrucous leukoplakia is a high risk precancerous lesi on with a high mortality rate, Because of both the propensity for prog ression to dysplasia and malignancy, as well as a high recurrence rate , these patients must be treated aggressively and followed carefully.