Laser evaporation versus laser excision of oral leukoplakia: A retrospective study with long-term follow-up.

The study makes a comparison between two surgical approaches for the treatment of oral leukoplakia (OL) in terms of recurrence in a well-defined cohort of patients with a long-term follow-up period. The cohort consisted of 77 OL patients divided into 2 groups. Group 1: 47 patients treated with laser evaporation using a Nd:YAG laser. Group 2: 30 patients treated with a CO2 laser for excision. Clinical and histological examinations were performed for the diagnosis of OL before treatment. We included OLs with or without dysplasia. The mean follow-up period was 60 ± 32.49 months. Of the 77 patients, 22 (28.5%) showed recurrence during the follow-up period. No significant difference was found between the two treatments (χ(2) = 2.6; p = 0.2). However, CO2 laser excision resulted in better results than the Nd:YAG laser evaporation, considering the non-homogeneous OLs (χ(2) = 3.9; p = 0.04) and OLs with mild dysplasia (χ(2) = 4.6; p = 0.03). The study makes a comparison between our results and articles from the literature, and suggests when each of the two surgical approaches is most appropriate.

Del Corso G ，Gissi DB ，Tarsitano A ，Costabile E ，Marchetti C ，Montebugnoli L ，Foschini MP ... -  《-》

The treatment of oral leukoplakia with the CO2 laser: A retrospective study of 65 patients.

The use of CO2 laser has become a routine procedure for the treatment of oral leukoplakia. In this retrospective study, we evaluated 65 patients with oral leukoplakia treated with CO2 laser vaporization. The main location was the tongue (n = 21/65, 32.3%). The initial biopsy showed mild/moderate dysplasia in almost half the patients (n = 29, 44.6%) and hyperplasia without dysplasia in around a third of the patients (n = 21, 32.3%). The recurrence and malignant transformation rates were 33.8% (n = 22) and 15.4% (n = 10), respectively. The follow-up mean (standard deviation) was 15.0 (10.6) months. The procedure-related complications rate was 7.7% (n = 5). The Kaplan-Meier curves for time to recurrence showed differences only for gingiva lesions compared to tongue lesions (log rank, p = 0.032). Malignant leukoplakia transformation is independent of treatment, although it seems advisable to treat leukoplakia with or without dysplasia.

Mogedas-Vegara A ，Hueto-Madrid JA ，Chimenos-Küstner E ，Bescós-Atín C ... -  《-》

Clinical predictors of oral leukoplakia recurrence following CO₂ laser vaporization.

The objective of this study was to determine whether risk of early leukoplakia recurrence (within 3 months) following carbon dioxide (CO2) laser removal varies by clinical characteristics including lesion size, site and accessibility of margins. A retrospective cohort study included patients with oral leukoplakia who had their first CO2 laser surgery for removal of oral leukoplakia between 2005 and 2010 at the UCSF oral medicine clinic. Twenty-six patients with 32 separate lesions met the eligibility criteria after a clinic database search was followed by review of clinical notes and biopsy reports from existing patient charts. Data analysis included computation of summary statistics, and logistic regression analyses to evaluate recurrence of leukoplakia by clinical characteristics of the lesions. Patient data and the characteristics of lesions were evaluated as possible predictors of early recurrence following laser removal; these included age, sex, duration, size, appearance and histopathology of the lesion. The only one that reached statistical significance was poor accessibility of the margins of the lesion (vs. good accessibility, OR = 24.57 (95% CI: 1.59-16.68), p = 0.016); the probability for trend for good, questionable, and poor accessibility was 0.0028. This finding remained significant after controlling for age, sex, duration and size of lesion. Four out of five lesions with poor accessibility showed recurrence at 3 months. Of these, three involved the gingiva and one the lateral tongue. This study has identified poor accessibility of the lesion margins as a predictor for early recurrence of leukoplakia following laser removal. Other variables evaluated did not reach statistical significance, possibly due to lack of power.

Chainani-Wu N ，Lee D ，Madden E ，Sim C ，Collins K ，Silverman S Jr ... -  《-》

The results of CO2 laser surgery in patients with oral leukoplakia: a 25 year follow up.

van der Hem PS ，Nauta JM ，van der Wal JE ，Roodenburg JL ... -  《ORAL ONCOLOGY》

Treatment of oral leukoplakia with carbon dioxide and potassium-titanyl-phosphate lasers: a comparison.

To determine whether the treatment of oral leukoplakia with potassium-titanyl-phosphate (KTP) lasers versus CO(2) lasers results in lower recurrence rates. Retrospective data were collected from the records of 30 patients (mean age 75.6 years) with 35 primary oral leukoplakia who had their lesions ablated by KTP laser, and 45 patients (mean age 59.9 years) with 59 primary oral leukoplakia who had CO(2) laser treatment. The recurrence rates of lesions between these 2 groups was then compared. A statistically significant (P = .049) reduction in recurrence rates for those patients treated with KTP lasers versus CO(2) lasers was found. The use of KTP lasers for the treatment of oral leukoplakia may result in lower recurrence rates than when using CO(2) lasers.

Lim B ，Smith A ，Chandu A 《-》