The efficacy of diode laser removal of leukoplakias on the tongue and in lower buccal cavity compared to other buccal cavity locations. A two-year study
Abstract
Introduction. Leukoplakias of the buccal cavity are premalignant lesions with a significant 0-20% potential for malignant transformation.
In addition to active follow-up screening procedures, a number of surgical interventions are recommended for their removal. One of the preferred procedures is laser ablation with consecutive histopathology using one of the many types of lasers.
The efficacy of such procedure with respect to the lesion location is, however, unclear. Many studies are contradictory.
Some shows laser ablations as prevention of malignisation other see it as increased risk. Aim of this is to test treatment in different locations for two years.
Material and method. An outpatient ablation by a 980mm diode laser of lesions on the tongue and in the lower buccal cavity (Group A) and lesions in other parts of the buccal cavity (Group B) were performed under local anaesthesia.
In total, 76 lesions were treated in 66 patients. Recurrence after 1, 3, 6, 9, 12, and 24 months were followed up.
Initially, all lesions were histopathologically tested. Concurrently, the subjective tolerance of the procedure was monitored, using a 1 (ideal) to 5 (worst) scale.
Results. Clearing rate of lesions was of 84.6% for Group A and of 94.7% for Group B.
In two patients (3% of Group A) malignant transformation occurred which was not observed in Group B. Patient toleration in various time intervals was always higher in Group B, but generally was very high in both groups.
Conclusion. Malignant transformation of leukoplakias does occur even after laser ablation, and for this reason it is necessary to subject the patients to systematic follow-ups.
It is significantly higher risk of recurrences and malign transformation in tongue and oral base. Laser ablation is a simple and well-tolerated procedure with high clearing rate.