Treatment and follow-up of oral dysplasia - a systematic review and meta-analysis
Mehanna, Hisham M., Rattay, Tim, Smith, Joel and McConkey, Christopher C.. (2009) Treatment and follow-up of oral dysplasia - a systematic review and meta-analysis. Head & Neck, Vol.31 (No.12). pp. 1600-1609. ISSN 10433074Full text not available from this repository.
Official URL: http://dx.doi.org/10.1002/hed.21131
Background. The aim of this study was to inform an evidence-based management policy for oral dysplastic lesions.
Methods. Systematic review was performed with meta-analysis. Studies reporting follow-up of patients with histologically confirmed oral dysplasia were included. Outcome measures included malignant transformation rate (MTR) and time to malignant transformation (TMT). Subgroup analysis was performed by histologic grade, clinical risk factors, and treatment modality. Heterogeneity was assessed.
Results. Fourteen nonrandomized studies, reporting on 992 patients, were included. There was considerable heterogeneity between studies: mean overall MTR = 12.1% (confidence interval: 8.1%, 17.9%) and mean TMT = 4.3 years. Histologic grade significantly affected mean MTR (p < .008). Lesions that were not excised demonstrated considerably higher MTR than those that were excised (p = .003).
Conclusions. Oral dysplasia showed a significant rate of transformation to cancer, which was related to grade and was decreased significantly but not eliminated by excision. This suggested the need for excision and continued surveillance. (C) 2009 Wiley Periodicals, Inc. Head Neck 31: 1600-1609, 2009
|Item Type:||Journal Article|
|Subjects:||R Medicine > RF Otorhinolaryngology
R Medicine > RD Surgery
|Divisions:||Faculty of Medicine > Warwick Medical School|
|Journal or Publication Title:||Head & Neck|
|Publisher:||John Wiley & Sons Ltd.|
|Official Date:||December 2009|
|Number of Pages:||10|
|Page Range:||pp. 1600-1609|
|Access rights to Published version:||Restricted or Subscription Access|
Actions (login required)