CLINICOPATHOLOGICAL AND SURGICAL CORRELATION IN MANAGEMENT OF ORAL POTENTIALLY MALIGNANT DISORDERS WITH DYSPLASIA: A RETROSPECTIVE ANALYSIS

Abstract

Background: Oral potentially malignant disorders (OPMDs) such as leukoplakia, erythroplakia, oral submucous fibrosis, and erosive lichen planus carry a risk of transformation into oral squamous cell carcinoma (OSCC), especially when epithelial dysplasia is present. Early diagnosis and appropriate surgical intervention are crucial for prevention.

Objective: To analyze the clinicopathological features of dysplastic OPMDs and evaluate surgical outcomes including recurrence and malignant transformation.

Methodology: This retrospective study evaluated 120 patients diagnosed with OPMDs and histologically confirmed dysplasia from 2018 to 2024. Data on lesion type, site, dysplasia grade, treatment modality, and clinical outcomes were collected. Dysplasia was classified as mild, moderate, or severe based on WHO criteria. Management included surgical excision, laser ablation, or observation.

Results: Leukoplakia was the most common lesion (50%), followed by erythroplakia (20%), oral submucous fibrosis (15%), and erosive lichen planus (15%). Histopathologically, 40% showed mild dysplasia, 35% moderate, and 25% severe. Surgical excision was performed in 85% of cases. Recurrence occurred in 14 patients (11.7%) and malignant transformation in 6 (5%), predominantly in severe dysplasia cases (16.7%). Lesions on the tongue and floor of the mouth had higher transformation rates. Conservative management in mild cases with habit cessation was successful, with no progression observed.

Conclusion: Severity of dysplasia significantly influences clinical outcomes. Surgical excision remains the gold standard for moderate to severe dysplasia, reducing risk of recurrence and malignancy. Conservative management may be appropriate for selected mild dysplasia cases under close follow-up.