Metastases of OSCC Based on Oral Lichen Ruber Planus

SIMPLE SUMMARY: Oral lichen ruber planus is a poorly understood chronic inflammatory disease of the oral mucosa and can cause malignant transformation into oral squamous cell carcinoma. This study is to our knowledge the first study examining the behavior of lymph nodal spreading in OSCC based on OLP and compares it to OSCC without OLP. Mostly, OSCC with OLP are highly differentiated tumors and come with a lower risk factor for lymph nodal spreading. Secondar metachronous tumor appears more often in patients suffering from OSCC based on OLP than in the comparison group. This study aims to evaluate the oncological characteristics of OSCC with OLP and compare them to a group with OSCC without OLP. ABSTRACT: Oral lichen ruber planus (OLP) is a poorly understood chronically inflammatory disease of the oral mucosa. Malignant transformation into oral squamous cell carcinoma (OSCC) is reported in between 1–2% of cases in the literature. After malignant transformation, surgical treatment—meaning tumor resection combined with neck dissection—is recommended. The recommended extent of treatment is controversial in the literature because this kind of OSCC is often a highly differentiated tumor with a lower risk for lymph nodal spreading. This study aims to overview 103 patients treated in our department due to OLP. The primary outcome parameter was the development of metastases in OLP patients compared to a group of OSCC patients without OLP and the comparison of survival in between both groups. Statistical analysis showed a significantly lower risk for patients with OSCC and with OLP for lymph nodal spreading (p = 0.013). Patients with OSCC and without OLP had a 4.76-higher risk for lymph nodal spreading. On the other hand, second metachronous tumor occurred more often in patients with OSCC and OLP. Overall, OSCC based on OLP occurs more often in female patients, is more highly differentiated and comes with a lower risk for metastases but has a higher risk for second metachronous tumors. Therefore, special attention should be paid to patients with OSCC based on OLP when planning adjuvant therapy and clinical follow-up. The indication for postoperative radiation should be made cautiously in this case, and clinical controls should be performed more closely due to the risk of recurrent disease or tumors at different locations.