ABSTRACT
Background: Early diagnosis and timely management of potentially malignant oral disorders may prevent malignant transformation and prompt diagnosis of frank malignancies favours better prognosis. The aim of this study was to evaluate the outcome of surgical management of oral potentially malignant disorders of the oral cavity and observe the prevalence of recurrence at the primary site and occurrence of another potentially malignant lesion in these patients. Methods: The study participants included patients who had undergone clinical oral examination, surgical excision of biopsy-proven cases of dysplastic oral potentially malignant disorders (leukoplakia, erythroplakia, non-healing ulcerative and erosive areas, etc.) who were on routine follow-up as per the standard guidelines. These patients were followed up closely during each monthly follow-up visit for the first year. The patients were then prospectively analysed for any recurrence of lesion. On follow-up visits, detailed clinical oral examination was done to note the prevalence of a new lesion in any oral cavity sub site other than the previous site. If a new lesion was detected, then biopsy followed by surgical excision was followed as per standard guidelines. The follow-up period after the second surgical intervention was 12 months. Results: Fifty patients with potentially malignant oral disorders underwent surgical excision. The majority of the study subjects were males (39/50) and 41 of them were below 65 years of age. Of 50 patients, 13 (26%) had second oral potentially malignant lesion other than the primary site. The rate of recurrence of the lesions at the primary site was 4% (2/50). Of these patients with recurrence, all had malignant transformation (2/2). Also, patients who were initially diagnosed with moderate dysplasia had a higher chance of recurrence. A second lesion at a site different from the primary lesion was seen in 26% of the cases. Conclusion: Surgical management of such lesions with one-centimetre oncological margins in all dimensions contrary to the routine five millimetre surgical margins reduces the chance of recurrence.
ABSTRACT
BACKGROUND: The oral potentially malignant disorders (OPMDs) can impair the quality of life (QOL) of an individual. The evaluation of various aspects of life getting affected will help the health service providers to better comprehend the problems faced by the patients. This study aimed to evaluate the postoperative QOL of surgically treated patients for OPMDs. MATERIALS AND METHODS: It was a cross-sectional study done on 45 follow-up patients, aged 24-80 years, who were surgically treated for OPMDs. A performa with questions regarding sociodemographics, personal, and abusive habits and a questionnaire on QOL was used. Oral examination was done to analyze the oral mucosa for recurrence. Data were analyzed using frequency analysis and unpaired student's t-test to compare the mean scores. RESULTS: Several patients reported to have experienced a lot of pain (15, 33%), burning sensation on having spicy food (36, 80%), great difficulty in opening mouth (15, 33%), alteration in taste sensation (36, 80%), limiting of eating desired food (24, 53%), and dryness of mouth (7, 16%). Many patients felt very frustrated, depressed (9, 20%), and reported their condition to have affected their satisfaction with life (19, 42%). However, neither did social relationship with family and friends got affected by this nor did it add discomfort to them at parties, social functions, or get together. Their main concern was the likelihood of their oral condition progressing into cancer. There was a statistically significant difference in the QOL scores for habit of areca nut chewing (P = 0.05), erythroplakia lesions (P = 0.05), and recurrence of lesion (P = 0.02). CONCLUSION: OPMDs affected the physical, functional, and psychological well-being of study patients, caused discomfort, and affected their daily activities. However, the social well-being of patients was unaltered and a large number of patients were reportedly satisfied with their treatments. The timely diagnosis and management can improve the quality of life and prevent its progression to malignancy.
