Abstract
Oral leukoplakia （OL） is a representative disease of oral potentially malignant disorders （OPMDs） characterized by a significant risk of malignant transformation. The objective of its management is to precisely evaluate clinical and histopathological features, understand the risk factors associated with recurrence and malignant transformation, and minimize the risk of malignant transformation through appropriate intervention and follow-up. However, there is a lack of consensus regarding the specific indications for surgical intervention versus follow-up. This report reviews the clinical and histopathological factors associated with recurrence and malignant transformation of OL based on the latest literature.
Clinical morphology, anatomical site, and the degree of epithelial dysplasia are considered as critical prognostic indicators. Notably, recurrence following surgical excision serves as a potent predictor of malignant transformation. Therefore, achieving adequate surgical margins to minimize recurrence is an essential strategy when intervention is chosen. Conversely, a wait-and-see approach involving strict monitoring may be a viable option for certain pathological states to avoid unnecessary surgical morbidity, underscoring the importance of personalized management based on individual risk profiles.
Future perspectives necessitate the accumulation of evidence based on the Japanese population. Furthermore, the integration of objective prognostic systems — utilizing artificial intelligence and biomarkers — is expected to facilitate more precise and minimally invasive management strategies for OL.
