Factors affecting Clinical Outcomes after Treatment of Oral Leukoplakia with CO2 and Diode Laser

Introduction: To analyze factors that may affect recurrence, development of new lesions, and malignant transformation in patients with oral leukoplakia (OL) following surgical treatment with lasers. Materials and methods: A total of 40 patients were enrolled in this study, 17 females (mean age of 64.5 years; 33-88 years) and 23 males (mean age of 56.6 years; 28-84 years) with an overall mean age of 60.5 years. A total of 49 lesions were diagnosed and treated; 9 patients had more than one site affected. Mean time of follow-up was 22 months (6-71 months). Data were assessed by univariate Cox and multivariate Cox regression analyses. Results: Recurrence (OL at the same site of the initial lesion) was observed in 11 patients (27.5%) while 4 patients (10%) developed new lesions, and 2 patients (5%) experienced malignant transformation. Only two clinical factors were statistically associated with the outcome for the development of new lesions: patients ≥ 60 years and female gender (p < 0.1). Neither of the outcomes of recurrences and malignant transformations was significantly correlated with any of the risk factors analyzed. Conclusion: Surgical laser is not a deterrent for the outcomes evaluated; additionally, the design of this study did not allow us to determine whether the laser treatment had provided a great benefit by significantly reducing the rate of malignant transformation among the patients. Clinical significance: It is highly important to inform patients with OL that their condition can be treated, when possible, by surgical laser, and that this treatment may be helpful in bringing down the odds of malignant transformation of their lesions. In addition, the patients should also be brought to the attention of the necessity of a continued clinical monitoring regardless of the outcome following a surgical intervention