Excision of Oral Leukoplakias by CO2 Laser on an Out-Patient Basis: A Useful Procedure for Prevention and Early Detection of Oral Carcinomas

Author:

Chiesa Fausto1,Sala Luigi1,Costa Luigi1,Moglia Daniele1,Mauri Maurizio2,Podrecca Stefano1,Andreola Salvatore3,Marchesini Renato4,Bandieramonte Gaetano5,Bartoli Cesare5,Massara Giovanni6,Molinari Roberto1

Affiliation:

1. Department of Head and Neck Oncology

2. General Direction

3. Department of Pathology

4. Department of Health Physics

5. Department of Out-Patient Oncology, Istituto Nazionale per lo studio e la cura dei Tumori, Milano

6. ENT Department, Ospedale di Vigevano

Abstract

Several epidemiologic studies have shown that oral cancer develops among individuals with a prior diagnosis of an oral premalignant lesion. Canceration chance in these patients is 17 %, with the greatest rate occuring in the second year of observation. Based on this data, since 1981, 92 leucoplakias have been treated by out-patient laser surgery at the Istituto Nazionale Tumori of Milano. The therapeutic technique was laser excision to obtain a specimen for histology. Two groups were distinguished according to the diagnostic procedure. Thirtythree lesions (December 1981 to December 1982) were operated on without preliminary histologic examination, on the basis of a simple clinical diagnosis. Since January 1983 all leukoplakias have been biopsied in a systematic way and those negative for cancer treated with laser. Histology of the specimen showed 5 squamous cell carcinomas (15 %) in the group of patients who did not undergo preoperative biopsy. Postoperative histology showed malignancy in 6 of 59 (10.2 %) cases in spite of negative preoperative biopsies. Speckled and erosive leukoplakias had the highest canceration rate. Three of 11 patients with cancer were treated by knife excision or interstitial needle implantation because of margins in tumoral tissue or because they were unvaluable for injury by heat. Results have been satisfactory, only 2 of 54 followed leukoplakias and none of the cancers recurred during a 2 year follow-up.

Publisher

SAGE Publications

Subject

Cancer Research,Oncology,General Medicine

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